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| 1 | Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis显示文摘AIM To perform meta-analysis of the use of Endocuff during average risk screening colonoscopy.METHODS Scopus, Cochrane databases, MEDLINE/Pub Med, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy(EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerS imonian and Laird models with the odds ratio(OR) to assess adenoma detection, cecal intubation rate, and complications performed. RESULTS Nine studies(n = 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma(OR = 1.49, 95%CI: 1.23-1.80; P = 0.03), and sessile serrated adenomas detection(OR = 2.34 95%CI: 1.63-3.36; P < 0.001). There was no significant difference in cecal intubation rates between the EACgroup and standard colonoscopy(OR = 1.26, 95%CI: 0.70-2.27, I2 = 0%; P = 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for perforation.CONCLUSION The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy. | Matthew Chin William Karnes M Mazen Jamal John G Lee Robert Lee Jason Samarasena Matthew L Bechtold Douglas L Nguyen | 2016 | World Journal of Gastroenterology2016，22，43： | 4 |
| 2 | Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature显示文摘AIM:To critically review and summarize the literature on nutritional and health outcomes of semi-elemental formulations on various nutritionally vulnerable patient populations who are unable to achieve adequate nutrition from standard oral diets.METHODS:We conducted a comprehensive literature search of Pubmed and Embase databases.We manually screened articles that examined nutritional and health outcomes(e.g.,growth,disease activity,gastrointestinal impairment,mortality,and economic impact)among various patient groups receiving semi-elemental diets.This review focused on full-text articles of randomized controlled clinical trials and other intervention studies,but pertinent abstracts and case studies were also included.Results pertaining primarily to tolerance,digestion,and absorption were summarized for each patient population in this systematic review.RESULTS:Results pertaining primarily to tolerance,digestion,and absorption were summarized for each patient population.The efficacy of semi-elemental whey hydrolyzed protein(WHP)diet have been reported in various nutritionally high risk patient populations including-Crohn’s disease,short bowel syndrome,acute and chronic pancreatitis,cerebral palsy,cystic fibrosis,cerebrovascular accidents,human immunodeficiency virus,critically ill,and geriatrics.Collectively,the evidence from the medical literature indicates that feeding with a semi-elemental diet performs as well or better than parenteral or amino acid based diets in terms of toler-ance,digestion,and nutrient assimilation measures across various disease conditions.CONCLUSION:Based on this comprehensive review of the literature,patient populations who have difficulty digesting or absorbing standard diets may be able to achieve improved health and nutritional outcomes through the use of semi-elemental WHP diets. | Dominik D Alexander Lauren C Bylsma Laura Elkayam Douglas L Nguyen | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，2： | 3 |
| 3 | Bleeding risk with clopidogrel and percutaneous endoscopic gastrostomy显示文摘AIM To compare bleeding within 48 h in patients undergoing percutaneous endoscopic gastrostomy(PEG) with or without clopidogrel.METHODS After institutional review board approval, a retrospective study involving a single center was conducted on adult patients having PEG(1/08-1/14). Patients were divided into two groups: Clopidogrel group consisting of those patients taking clopidogrel within 5 d of PEG and the non-clopidogrel group including those patients not taking clopidogrel within 5 d of the PEG.RESULTS Three hundred and nineteen PEG patients were found. One hundred and sixty-eight males and 151 females with mean body mass index 28.47 ± 9.75 kg/m2 and mean age 65.03 ± 16.11 years were identified. Thirtythree patients were on clopidogrel prior to PEG with 286 patients not on clopidogrel. No patients in either group developed hematochezia, melena, or hematemesiswithin 48 h of percutaneous endoscopic gastrostomy(PEG). No statistical differences were observed between the two groups with 48 h for hemoglobin decrease of > 2 g/dL(2 vs 5 patients; P = 0.16), blood transfusions(2 vs 7 patients; P = 0.24), and repeat endoscopy for possible gastrointestinal bleeding(no patients in either group). CONCLUSION Based on the results, no significant post-procedure bleeding was observed in patients undergoing PEG with recent use of clopidogrel. | Umair Sohail Chela Harleen Amin O Mahdi Murtaza Arif Douglas L Nguyen Matthew L Bechtold | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，16： | 2 |
| 4 | Prophylactic tracheal intubation for upper GI bleeding: A meta-analysis显示文摘AIM: To evaluate usefulness of prophylactically intubating upper gastrointestinal bleeding(UGIB) patients. METHODS: UGIB results in a significant number of hospital admissions annually with endoscopy being the key intervention. In these patients, risks are associated with the bleeding and the procedure, including pulmonary aspiration. However, very little literature is available assessing the use of prophylactic endotracheal intubation on aspiration in these patients. A comprehensive search was performed in May 2014 in Scopus, CINAHL, Cochrane databases, Pub Med/Medline, Embase, and published abstracts from national gastroenterology meetings in the United States(2004-2014). Included studies examined UGIB patients and compared prophylactic intubation to no intubation before endoscopy. Meta-analysis was conducted using Rev Man 5.2 by Mantel-Haenszel and Der Simonian and Laird models with results presented as odds ratio for aspiration, pneumonia(within 48 h), and mortality. Funnel plots were utilized for publication bias and I2 measure of inconsistency for heterogeneity assessments. RESULTS: Initial search identified 571 articles. Of these articles, 10 relevant peer-reviewed articles in English and two relevant abstracts were selected to review by two independent authors(Almashhrawi AA and Bechtold ML). Of these studies, eight were excluded: Five did not have a control arm, one was a letter the editor, one was a survey study, and one was focused on prevention of UGIB. Therefore, four studies(N = 367) were included. Of the UGIB patients prophylactically intubated before endoscopy, pneumonia(within 48 h) was identified in 20 of 134(14.9%) patients as compared to 5 of 95(5.3%) patients that were not intubated prophylactically(P = 0.02). Despite observed trends, no significantdifferences were found for mortality(P = 0.18) or aspiration(P = 0.11).CONCLUSION: Pneumonia within 48 h is more likely in UGIB patients who received prophylactic endotracheal intubation prior to endoscopy. | Ashraf A Almashhrawi Rubayat Rahman Samuel T Jersak Akwi W Asombang Alisha M Hinds Hazem T Hammad Douglas L Nguyen Matthew L Bechtold | 2015 | World Journal of Meta-Analysis2015，3，1： | 1 |
| 5 | Strategies for overcoming anti-tumor necrosis factor drug antibodies in inflammatory bowel disease:Case series and review of literature显示文摘Anti-tumor necrosis factor(TNF) biologics are currentlyamongst the most widely used and efficacious therapies for inflammatory bowel disease(IBD). The development of therapeutic drug monitoring for infliximab and ada-limumab has allowed for measurement of drug levels and antidrug antibodies. This information can allow for manipulation of drug therapy and prediction of response. It has been shown that therapeutic anti-TNF drug levels are associated with maintenance of remission, and development of antidrug antibodies is predictive of loss of response. Studies suggest that a low level of drug antibodies, however, can at times be overcome by dose escalation of anti-TNF therapy or addition of an immunomodulator. We describe a retrospective case series of twelve IBD patients treated at the University of California-Irvine, who were on infliximab or adalimumab therapy and were found to have detectable but low-level antidrug antibodies. These patients underwent dose escalation of the drug or addition of an immunomodulator, with subsequent follow-up drug levels obtained. Eight of the twelve patients(75%) demonstrated resolution of antidrug antibodies, and were noted to have improvement in disease activity. Though data regarding overcoming low-level anti-TNF drug antibodies remains somewhat limited, cases described in the literature as well as our own experience suggest that this may be a viable strategy for preserving the use of an anti-TNF drug. Low-level anti-TNF drug antibodies may be overcome by dose escalation and/or addition of an immunomodulator, and can allow for clinical improvement in disease status. Therapeutic drug monitoring is an important tool to guide this strategy. | Mansi M Kothari Douglas L Nguyen Nimisha K Parekh | 2017 | World Journal of Gastrointestinal Pharmacology and Therapeutics2017，8，3： | 0 |
| 6 | Use of music during colonoscopy:An updated meta-analysis of randomized controlled trials显示文摘BACKGROUND Music seems to be beneficial in multiple clinical areas.Colonoscopy is a stressful event for patients,especially with conscious sedation.Music during colonoscopy has been evaluated in multiple randomized controlled trials(RCTs)with varied results.Even meta-analyses on the subject over the years have yielded inconsistent conclusions.Therefore,we conducted an up-to-date meta-analysis regarding music during colonoscopy.AIM To assess the effects of music played during colonoscopy on patients’perspectives and sedation requirements.METHODS Multiple large databases were aggressively searched(November 2018).RCTs comparing music to without music during colonoscopy on adult patients were included.Pooled estimates were calculated for sedative medication doses,total procedure time,and patients’experience,willingness to repeat procedure,and pain scores using odds ratio(OR)and mean difference(MD)with random effects model.RESULTS Eleven studies(n=988)were included.Music during colonoscopy showed a statistically significant reduction in procedure times(MD:-2.3 min;95%CI:-4.13 to-0.47;P=0.01)and patients’pain(MD:-1.26;95%CI:-2.28 to-0.24;P=0.02)while improving patients’experience(MD:-1.11;95%CI:-1.7 to-0.53;P<0.01)as compared to no music.No statistically significant differences were observed between music and no music during colonoscopy for midazolam(MD:-0.4 mg;95%CI:-0.9 to 0.09;P=0.11),meperidine(MD:-3.06 mg;95%CI:-10.79 to 4.67;P=0.44),or patients’willingness to repeat the colonoscopy(OR:3.89;95%CI:0.76 to 19.97;P=0.1).CONCLUSION Music appears to improve overall patient experience while reducing procedure times and patient pain.Therefore,music,being a non-invasive intervention,should be strongly considered during colonoscopy. | Ryan D Heath Nasim Parsa Michelle L Matteson-Kome Victoria Buescher Sami Samiullah Douglas L Nguyen Veysel Tahan Yezaz A Ghouri Srinivas R Puli Matthew L Bechtold | 2019 | World Journal of Meta-Analysis2019，7，9： | 0 |
| 7 | Split-dose vs same-day bowel preparation for afternoon colonoscopies:A meta-analysis of randomized controlled trials显示文摘BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages. | Nasim Parsa Eric A Grisham Courtney J Cockerell Michelle L Matteson-Kome Ramakrishna V Bysani SamiSamiullah Douglas L Nguyen Veysel Tahan Yezaz A Ghouri Srinivas R Puli Matthew L Bechtold | 2020 | World Journal of Meta-Analysis2020，8，6： | 0 |
| 8 | Hyoscine for polyp detection during colonoscopy: A meta-analysis and systematic review显示文摘AIM: To assess the role of hyoscine for polyp detectionduring colonoscopy.METHODS: Studies(randomized controlled trials orRCTs) that compared the use of hyoscine vs no hyo-scine or placebo for polyp detection during colonoscopywere included in our analysis. A search on multiple da-tabases was performed in September 2013 with searchterms being 'hyoscine and colonoscopy', 'hyoscineand polyp', 'hyoscine and adenoma', 'antispasmoticand colonoscopy', 'antispasmotic and adenoma', and'antispasmotic and polyp'. Jadad scoring was used toassess the quality of studies. The efficacy of hyoscinewas analyzed using Mantel-Haenszel model for polypand adenoma detection with odds ratio(OR). The I2measure of inconsistency was used to assess hetero-geneity(P < 0.05 or I2 > 50%). Statistical analysis was performed by RevMan 5.1. Funnel plots was used to assess publication bias.RESULTS: The search of the electronic databases identified 283 articles. Of these articles, eight published RCTs performed at various locations in Europe, Asia, and Australia were included in our meta-analysis, seven published as manuscripts and one published as an ab-stract(n = 2307). All the studies included patients with a hyoscine and a no hyoscine/placebo group and were of adequate quality(Jadad score ≥ 2). Eight RCTs as-sessed the polyp detection rate(PDR)(n = 2307). The use of hyoscine demonstrated no statistically significant difference as compared to no hyoscine or placebo for PDR(OR = 1.06; 95%CI: 0.89-1.25; P = 0.51). Five RCTs assessed the adenoma detection rate(ADR)(n = 2015). The use of hyoscine demonstrated no statisti-cally significant difference as compared to no hyoscine or placebo for ADR(OR = 1.12; 95%CI: 0.92-1.37; P = 0.25). Furthermore, the timing of hyoscine admin-istration(given at cecal intubation or pre-procedure) demonstrated no differences in PDR compared to no hyoscine or placebo. Publication bias or heterogeneity was not observed for any of the outcomes.CONCLUSION: Hyoscine use in patients undergoing colonoscopy does not appear to significantly increase the detection of polyps or adenomas. | Imran Ashraf Sohail Ashraf Sameer Siddique Douglas L Nguyen Abhishek Choudhary Matthew L Bechtold | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，11： | 0 |
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