scholarly journals Effect of Antifoaming Agent on Colorectal Benign Tumours in Colonoscopy: A Meta-Analysis

2020 ◽  
Author(s):  
Hu Zhang ◽  
Jing Liu ◽  
Lin Song Ma ◽  
Heng Zhang
Keyword(s):  
Detection Rate ◽  
Low Dose ◽  
Colorectal Adenomas ◽  
Cochrane Library ◽  
High Dose ◽  
Significant Finding ◽  
Antifoaming Agent ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Benign Tumours

Abstract Background: Although several trials have showed that addition of antifoaming agent to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agent has a beneficial role in detection of benign tumours during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the effect of detection of colorectal benign tumours.Methods: The PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps.Results: Twenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group with simethicone. We also found that simethicone could significantly improve the ADR in proximal colon, but did not affect the colorectal polyp detection rate (PDR). Furthermore, the subgroup analyses revealed that the beneficial effect of simethicone in the ADR among Asian (P=0.005) and ADR < 25% (P =0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of colorectal benign tumours.Conclusions: In summary, the addition of simethicone to PEG might benefit to improve diminutive adenomas in the right colon for colonoscopy in Asia. The low-dose simethicone was recommend to the detection of colorectal benign tumours. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

scholarly journals Efficacy of Combination Colonoscopy Using Modified Cap-assisted and Water-exchange Colonoscopy with Prone Position in the Detection of Colorectal Adenomas: A Retrospective Study

2021 ◽  
Author(s):  
Jihwan Ko ◽  
Hyung Wook Kim ◽  
Byung Gu Ko ◽  
Seong Ho Han
Keyword(s):  
Prone Position ◽  
Detection Rate ◽  
Water Exchange ◽  
Colorectal Adenomas ◽  
Conventional Colonoscopy ◽  
Polyp Detection ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Proximal Map

Abstract Background: The efficacy of cap-assisted and water-exchange colonoscopy for adenoma detection, individually or in combination, is well documented but the efficacy of the combination colonoscopy using the above methods with prone position for adenoma detection is unclear. We compared the effectiveness of the combination colonoscopy using modified cap-assisted and water-exchange colonoscopy with prone position (CWP) and conventional colonoscopy (CC) for adenoma detection.Methods: A total of 746 patients who underwent either CWP or CC, performed by two board-certified gastroenterologists between December 2019 and March 2020, were investigated retrospectively. Cap-assisted colonoscopy was modified using hooking and dragging maneuver. We evaluated the polyp detection rate (PDR), adenoma detection rate (ADR), and mean number of adenomas detected per procedure (MAP). Results: There was no significant difference in sex, age, the indication of colonoscopy and quality of bowel preparation between the two groups. The PDR, ADR, and proximal MAP were significantly higher in the CWP group than the CC group (PDR: 84.9% vs. 59.8%, P < 0.001; ADR: 70.1%, vs. 49.2%, P < 0.001; proximal MAP: 1.24 vs. 0.55, P < 0.001). Amongst males, total and proximal MAP were significantly higher in the CWP group than the CC group, respectively (2.28 ± 2.24 vs. 1.49 ± 1.92, P < 0.001; 1.73 ± 1.98 vs. 0.74 ± 1.21, P < 0.001). Conclusions: Combination colonoscopy is more effective than conventional colonoscopy for the PDR, ADR, and proximal MAP. Further studies assessing the synergistic or complementary effects of the combination are needed.

High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Rehab Abdelhamid Aboshama ◽  
Ahmed Mohamed Abdelhakim ◽  
Mohammad Abrar Shareef ◽  
Abdulhadi A. AlAmodi ◽  
Mohammad Sunoqrot ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Low Dose ◽  
Delivery Rate ◽  
Cochrane Library ◽  
High Dose ◽  
Safety And Efficacy ◽  
Labor Duration ◽  
Uterine Hyperstimulation ◽  
Cesarean Delivery Rate ◽  
Labor Augmentation

AbstractObjectivesTo compare the safety and efficacy between high dose and low dose oxytocin administration for labor augmentation.MethodsWe searched for the available studies during March 2020 in PubMed, Cochrane Library, Scopus, and ISI Web of science. All randomized clinical trials (RCTs) that assessed safety and efficacy of high dose vs. low dose oxytocin for labor augmentation were considered. The extracted data were entered into RevMan software. Dichotomous and continuous data were pooled as odds ratio (OR) and mean difference (MD) respectively, with the corresponding 95% confidence intervals (CI). Our main outcomes were cesarean delivery rate, spontaneous vaginal delivery rate, uterine hyperstimulation and tachysystole, and labor duration from oxytocin infusion.ResultsEight RCTs with 3,154 patients were included. High dose oxytocin did not reduce cesarean delivery rate compared to low dose oxytocin (OR=0.76, 95% CI [0.52, 1.10], p=0.15). After solving the reported heterogeneity, high dose oxytocin did not increase the rate of spontaneous vaginal deliveries vs. low dose oxytocin (OR=1.06, 95% CI [0.84, 1.32], p=0.64). Low dose oxytocin was linked to a significant decline in uterine hyperstimulation and tachysystole (p>0.001). A reduction in labor duration was found in high dose oxytocin group over low oxytocin regimen (MD=−1.02 h, 95% CI [−1.77, −0.27], p=0.008).ConclusionsWe found no advantages for high dose oxytocin over low dose oxytocin in labor augmentation except in reducing labor duration. Low dose oxytocin is safer as it decreases the incidence of uterine hyperstimulation and tachysystole. More trials are needed to confirm our findings.

scholarly journals Comparison of colonoscopy after colonic diverticulitis and positive fecal immunochemical tests for the detection of colorectal neoplasia

2021 ◽  
Vol 09 (03) ◽  
pp. E331-E337
Author(s):  
Dai Nakamatsu ◽  
Tsutomu Nishida ◽  
Shinji Kuriki ◽  
Li-sa Chang ◽  
Kazuki Aochi ◽  
...  
Keyword(s):  
Detection Rate ◽  
Colorectal Neoplasia ◽  
Acute Diverticulitis ◽  
Colonic Diverticulitis ◽  
Detection Rates ◽  
Positive Group ◽  
Asymptomatic Patients ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Acute Colonic Diverticulitis

Abstract Background and study aims The relationship between acute colonic diverticulitis and colorectal cancer (CRC) is unclear, but colonoscopy is recommended to exclude malignancy. We compared the detection rates for colorectal neoplasia in patients with colonic diverticulitis and asymptomatic patients who had positive fecal immunochemical tests (FITs). Patients and methods In total, 282 patients with acute colonic diverticulitis were hospitalized in our hospital from February 2011 to December 2019. Of them, 143 patients with diverticulitis and 1819 with positive FITs patients during the same period underwent colonoscopy without a prior colonoscopy within 5 years. We retrospectively compared these patients in terms of the invasive CRC rate, advanced neoplasia detection rate (ANDR), adenoma detection rate (ADR), and polyp detection rate (PDR). Results Compared to the diverticulitis group, the FIT-positive group had a significantly higher CRC rate (0 vs 2.7 %, P = 0.0061), ANDR (5.6 vs. 14.0 %, P = 0.0017), ADR (19.6 vs. 53.2 %, P < .0001), and PDR (44.1 vs. 91.0 %, P < .0001). Using 1:1 propensity score matching based on age and sex, we obtained 276 matched patients in both groups. After matching, no difference was found in the CRC rate (0 vs 0.7 %) or ANDR (5.8 vs 7.3 %) between groups, but the ADR and PDR were significantly higher in the FIT-positive group (20.3 vs 43.5 %, P < .0001; 45.7 % vs 86.2 %, P < .0001). Conclusion Patients with acute diverticulitis had lower ADRs and PDRs than patients with positive FITs.

Mo1557 Physician's Fatigue Influences on Adenoma Detection Rate and Polyp Detection Rate

2011 ◽  
Vol 73 (4) ◽  
pp. AB385-AB386
Author(s):  
Dongil Park ◽  
Young-Ho Kim ◽  
Suck-Ho Lee ◽  
Chang Kyun Lee ◽  
Chang Soo Eun ◽  
...  
Keyword(s):  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Polyp Detection ◽  
Polyp Detection Rate ◽  
Adenoma Detection

scholarly journals Combination Therapy with an SGLT2 Inhibitor as Initial Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (1) ◽  
pp. 45 ◽  
Author(s):  
Tamara Y. Milder ◽  
Sophie L. Stocker ◽  
Christina Abdel Shaheed ◽  
Lucy McGrath-Cadell ◽  
Dorit Samocha-Bonet ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Combination Therapy ◽  
Low Dose ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Cochrane Library ◽  
High Dose ◽  
Dose Combination ◽  
Inhibitor Combination

Background: Guidelines differ with regard to indications for initial combination pharmacotherapy for type 2 diabetes. Aims: To compare the efficacy and safety of (i) sodium-glucose cotransporter 2 (SGLT2) inhibitor combination therapy in treatment-naïve type 2 diabetes adults; (ii) initial high and low dose SGLT2 inhibitor combination therapy. Methods: PubMed, Embase and Cochrane Library were searched for randomised controlled trials (RCTs) of initial SGLT2 combination therapy. Mean difference (MD) for changes from baseline (HbA1c, weight, blood pressure) after 24–26 weeks of treatment and relative risks (RR, safety) were calculated using a random-effects model. Risk of bias and quality of evidence was assessed. Results: In 4 RCTs (n = 3749) there was moderate quality evidence that SGLT2 inhibitor/metformin combination therapy resulted in a greater reduction in HbA1c (MD (95% CI); −0.55% (−0.67, −0.43)) and weight (−2.00 kg (−2.34, −1.66)) compared with metformin monotherapy, and a greater reduction in HbA1c (−0.59% (−0.72, −0.46)) and weight (−0.57 kg (−0.89, −0.25)) compared with SGLT2 inhibitor monotherapy. The high dose SGLT2 inhibitor/metformin combination resulted in a similar HbA1c but greater weight reduction; −0.47 kg (−0.88, −0.06) than the low dose combination therapy. The RR of genital infection with combination therapy was 2.22 (95% CI 1.33, 3.72) and 0.69 (95% CI 0.50, 0.96) compared with metformin and SGLT2 inhibitor monotherapy, respectively. The RR of diarrhoea was 2.23 (95% CI 1.46, 3.40) with combination therapy compared with SGLT2 inhibitor monotherapy. Conclusions: Initial SGLT2 inhibitor/metformin combination therapy has glycaemic and weight benefits compared with either agent alone and appears relatively safe. High dose SGLT2 inhibitor/metformin combination therapy appears to have modest weight, but no glycaemic benefits compared with the low dose combination therapy.

scholarly journals Gaze patterns hold key to unlocking successful search strategies and increasing polyp detection rate in colonoscopy

Endoscopy ◽  
2018 ◽  
Vol 50 (07) ◽  
pp. 701-707 ◽  
Author(s):  
Mariam Lami ◽  
Harsimrat Singh ◽  
James Dilley ◽  
Hajra Ashraf ◽  
Matthew Edmondon ◽  
...  
Keyword(s):  
Eye Tracking ◽  
Detection Rate ◽  
Surrogate Marker ◽  
Polyp Detection ◽  
Gaze Patterns ◽  
Successful Search ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Important Quality ◽  
Visual Gaze

Abstract Background The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR. Methods 18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses – screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis. Results Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, P = 0.02; anatomy: r = 0.62, P < 0.01). Fixation distribution to the “bottom U” of the screen in screen-based analysis was positively correlated with PDR (r = 0.62, P = 0.01). HMM demarcated the VGPs into three PDR groups. Conclusion This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.

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