scholarly journals Efficacy of Over-The-Scope Clip Method as a Novel Hemostatic Therapy for Colonic Diverticular Bleeding

2021 ◽  
Vol 10 (13) ◽  
pp. 2891
Author(s):  
Koichiro Kawano ◽  
Mamoru Takenaka ◽  
Reiko Kawano ◽  
Daisuke Kagoshige ◽  
Yuta Kawase ◽  
...  
Keyword(s):  
Adverse Events ◽  
Success Rate ◽  
Early Phase ◽  
Medical Center ◽  
Arterial Embolization ◽  
Massive Bleeding ◽  
Diverticular Bleeding ◽  
Bleeding Rate ◽  
Colonic Diverticular Bleeding ◽  
Over The Scope Clip

Colonic diverticular could bleed recurrently, and, sometimes, fatal massive bleeding could occur. However, the choice of endoscopic hemostasis remains controversial. Although the over-the-scope clip (OTSC) method has been reported to be effective, it has not been fully evaluated due to the small number of cases. This study aimed to evaluate the efficacy of the OTSC method for colonic diverticular bleeding. Between August 2017 and December 2020, 36 consecutive patients, including those who could not be treated using endoscopic band ligation (EBL) and those in whom re-bleeding had occurred after EBL, underwent the OTSC method for hemostasis of colonic diverticular bleeding at Hyogo Prefectural Awaji Medical Center. The procedure success rate, adverse events rate, early phase re-bleeding rate (within 30 days following primary hemostasis), and the requirement rate for additional transcatheter arterial embolization (TAE) or surgery were the outcomes assessed. The outcomes were procedure success rate 100%, adverse events rate 0%, early phase re-bleeding rate 8.3%, and additional TAE or surgery rate 0%. These results suggest that the OTSC method is a safe and effective treatment for managing colonic diverticular bleeding.

scholarly journals Treatment of acute colonic diverticular bleeding in high risk patients, using an over-the-scope clip: a case series

Endoscopy ◽  
2016 ◽  
Vol 48 (S 01) ◽  
pp. E383-E385 ◽  
Author(s):  
Edris Wedi ◽  
Daniel von Renteln ◽  
Carlo Jung ◽  
Irina Tchoumak ◽  
Victor Roth ◽  
...  
Keyword(s):  
High Risk ◽  
Case Series ◽  
Diverticular Bleeding ◽  
High Risk Patients ◽  
Risk Patients ◽  
Colonic Diverticular Bleeding ◽  
Over The Scope Clip

scholarly journals Endoscopic treatment of colonic diverticular bleeding using an over-the-scope clip

Endoscopy ◽  
2016 ◽  
Vol 48 (S 01) ◽  
pp. E160-E160 ◽  
Author(s):  
Andreas Probst ◽  
Georg Braun ◽  
Stefan Goelder ◽  
Helmut Messmann
Keyword(s):  
Endoscopic Treatment ◽  
Diverticular Bleeding ◽  
Colonic Diverticular Bleeding ◽  
Over The Scope Clip

scholarly journals High-Dose Barium Impaction Therapy Is Useful for the Initial Hemostasis and for Preventing the Recurrence of Colonic Diverticular Bleeding Unresponsive to Endoscopic Clipping

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ryota Niikura ◽  
Naoyoshi Nagata ◽  
Kazuyoshi Yamano ◽  
Takuro Shimbo ◽  
Naomi Uemura
Keyword(s):  
Blood Transfusion ◽  
Massive Bleeding ◽  
High Dose ◽  
Recurrent Bleeding ◽  
Multidetector Row Computed Tomography ◽  
Diverticular Bleeding ◽  
Interventional Angiography ◽  
Short Period ◽  
Colonic Diverticular Bleeding ◽  
Endoscopic Clipping

Most cases of colonic diverticular bleeding stop spontaneously, but some patients experience massive bleeding that requires emergency treatment. Endoscopy can be useful when the bleeding source is identified. However, bleeding sometimes recurs within a short period despite the successful endoscopic treatment. Under such conditions, more invasive therapy such as interventional angiography or surgery is required and can prolong hospitalization and involve frequent blood transfusions. We report the case of a 68-year-old woman who presented with massive hematochezia. The patient was in hemorrhagic shock and required 16 units of blood transfusion to recover to general condition. We performed multidetector row computed tomography, but it showed no sites of bleeding. We conducted colonoscopy and identified the source of bleeding as colonic diverticula. We treated the bleeding with endoscopic hemoclips and achieved hemostasis, but bleeding recurred the next day. Four units of blood transfusion were required. We tried high-dose barium impaction therapy to avoid further blood transfusion and surgery. No complications or recurrent bleeding was observed for an 18-month period. Therapeutic barium enema is an option for colonic diverticular bleeding unresponsive to endoscopic clipping and may be effective for preventing recurrent bleeding.

scholarly journals Endoscopic treatment of colonic diverticular bleeding with an over-the-scope clip after failure of endoscopic band ligation

VideoGIE ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. 252-254
Author(s):  
Kenji Yamazaki ◽  
Akinori Maruta ◽  
Hiroki Taniguchi ◽  
Kosuke Hasegawa ◽  
Masahito Shimizu
Keyword(s):  
Endoscopic Treatment ◽  
Diverticular Bleeding ◽  
Band Ligation ◽  
Colonic Diverticular Bleeding ◽  
Endoscopic Band Ligation ◽  
Over The Scope Clip

scholarly journals Algorithmic prediction of failure modes in healthcare

2020 ◽  
Author(s):  
Ayala Kobo-Greenhut ◽  
Ortal Sharlin ◽  
Yael Adler ◽  
Nitza Peer ◽  
Vered H Eisenberg ◽  
...  
Keyword(s):  
Adverse Events ◽  
Failure Modes ◽  
Medical Center ◽  
Hazard Analysis ◽  
Working Hours ◽  
Hazard Identification ◽  
Patient Identification ◽  
Complete Identification ◽  
Before And After ◽  
Fmea Method

Abstract Background Preventing medical errors is crucial, especially during crises like the COVID-19 pandemic. Failure Modes and Effects Analysis (FMEA) is the most widely used prospective hazard analysis in healthcare. FMEA relies on brainstorming by multi-disciplinary teams to identify hazards. This approach has two major weaknesses: significant time and human resource investments, and lack of complete and error-free results. Objectives To introduce the algorithmic prediction of failure modes in healthcare (APFMH) and to examine whether APFMH is leaner in resource allocation in comparison to the traditional FMEA and whether it ensures the complete identification of hazards. Methods The patient identification during imaging process at the emergency department of Sheba Medical Center was analyzed by FMEA and APFMH, independently and separately. We compared between the hazards predicted by APFMH method and the hazards predicted by FMEA method; the total participants’ working hours invested in each process and the adverse events, categorized as ‘patient identification’, before and after the recommendations resulted from the above processes were implemented. Results APFMH is more effective in identifying hazards (P < 0.0001) and is leaner in resources than the traditional FMEA: the former used 21 h whereas the latter required 63 h. Following the implementation of the recommendations, the adverse events decreased by 44% annually (P = 0.0026). Most adverse events were preventable, had all recommendations been fully implemented. Conclusion In light of our initial and limited-size study, APFMH is more effective in identifying hazards (P < 0.0001) and is leaner in resources than the traditional FMEA. APFMH is suggested as an alternative to FMEA since it is leaner in time and human resources, ensures more complete hazard identification and is especially valuable during crisis time, when new protocols are often adopted, such as in the current days of the COVID-19 pandemic.

scholarly journals Development of Machine Learning Models for Prediction of Smoking Cessation Outcome

2021 ◽  
Vol 18 (5) ◽  
pp. 2584
Author(s):  
Cheng-Chien Lai ◽  
Wei-Hsin Huang ◽  
Betty Chia-Chen Chang ◽  
Lee-Ching Hwang
Keyword(s):  
Machine Learning ◽  
Smoking Cessation ◽  
Success Rate ◽  
Prediction Models ◽  
Smoking Status ◽  
Medical Center ◽  
Machine Learning Algorithms ◽  
Classification And Regression Tree ◽  
Support Vector ◽  
Smoking Cessation Outcome

Predictors for success in smoking cessation have been studied, but a prediction model capable of providing a success rate for each patient attempting to quit smoking is still lacking. The aim of this study is to develop prediction models using machine learning algorithms to predict the outcome of smoking cessation. Data was acquired from patients underwent smoking cessation program at one medical center in Northern Taiwan. A total of 4875 enrollments fulfilled our inclusion criteria. Models with artificial neural network (ANN), support vector machine (SVM), random forest (RF), logistic regression (LoR), k-nearest neighbor (KNN), classification and regression tree (CART), and naïve Bayes (NB) were trained to predict the final smoking status of the patients in a six-month period. Sensitivity, specificity, accuracy, and area under receiver operating characteristic (ROC) curve (AUC or ROC value) were used to determine the performance of the models. We adopted the ANN model which reached a slightly better performance, with a sensitivity of 0.704, a specificity of 0.567, an accuracy of 0.640, and an ROC value of 0.660 (95% confidence interval (CI): 0.617–0.702) for prediction in smoking cessation outcome. A predictive model for smoking cessation was constructed. The model could aid in providing the predicted success rate for all smokers. It also had the potential to achieve personalized and precision medicine for treatment of smoking cessation.

scholarly journals Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jongbeom Shin ◽  
Boram Cha ◽  
Jin-Seok Park ◽  
Weonjin Ko ◽  
Kye Sook Kwon ◽  
...  
Keyword(s):  
Success Rate ◽  
Salvage Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Effective Control ◽  
Success Rates ◽  
Gastrointestinal Tumor ◽  
Bleeding Rate ◽  
Tumor Bleeding ◽  
Hemostatic Powder ◽  
Upper Gastrointestinal

Abstract Background Gastrointestinal tumor bleeding remains a clinical challenge because it is difficult to treat with conventional endoscopic hemostatic options. Recently, an endoscopic hemostatic powder (UI-EWD) was developed and reported to provide effective control of upper gastrointestinal bleeding. The aim of current study was to evaluate the feasibility and efficacy of this novel hemostatic powder in tumor bleeding. Methods A total of 41 consecutive patients with upper gastrointestinal tumor bleeding were included. UI-EWD was applied in all patients as an auxiliary hemostatic method as a salvage therapy or monotherapy during endoscopic treatment. Hemostasis success rates, adverse event related to UI-EWD, and rates of re-bleeding were evaluated. Results In all cases, UI-EWD application was successful at tumor bleeding sites. Immediate hemostasis occurred in 40/41 (97.5%) patients, and re-bleeding within 28 days occurred in 10 of 40 (22.5%) patients that achieved initial hemostasis. The success rate of immediate hemostasis for UI-EWD monotherapy was 100% (23/23). The re-bleeding rate at 28 days after UI-EWD monotherapy was 26.1% (6/23). No adverse events associated with UI-EWD application were encountered. Conclusions The success rate of UI-EWD for immediate hemostasis in cases of GI tumor bleeding was excellent and UI-EWD produced promising results with respect to the prevention of re-bleeding. Based on these results, we suggest that UI-EWD be considered an effective salvage therapy or even monotherapy for GI tumor bleeding.

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