Impact of Moderate versus Deep Sedation and Trainee Participation on Adenoma Detection Rate-Analysis of a Veteran Population

Background/Aims The adenoma detection rate (ADR) is used as a quality indicator for screening and surveillance colonoscopy. The study aimed to determine if moderate versus deep sedation affects the outcomes of the ADR and other quality metrics in the veteran population. Methods A retrospective review of colonoscopies performed at Memphis Veterans Affairs Medical Center over a one-year period was conducted. A total of 900 colonoscopy reports were reviewed. After exclusion criteria, a total of 229 index, average-risk screening colonoscopies were identified. Data were collected to determine the impact of moderate (benzodiazepine plus opioids) versus deep (propofol) sedation on the ADR, polyp detection rate (PDR), and withdrawal time. Results Among 229 screening colonoscopies, 103 (44.9%) used moderate sedation while 126 (55%) were done under deep sedation. The ADR and PDR were not significantly different between moderate versus deep sedation at 35.9% vs. 37.3% (p=0.82) and 58.2% vs. 48.4% (p=0.13), respectively. Similarly, there was no significant difference in withdrawal time between moderate and deep sedation (13.4 min vs. 14 min, p=0.56) during screening colonoscopies. Conclusions In veterans undergoing index, average-risk screening colonoscopies, the quality metrics of the ADR, PDR, and withdrawal time are not influenced by deep sedation compared with moderate sedation

Un caso de cardiomiopatía dilatada en un paciente venezolano con polimiositis

Polymyositis is an autoimmune disease, characterized by the inflammation of muscular tissues. It belongs to the family of inflammatory myopathies, along with dermatomyositis, inclusion-bodies myositis and necrotizing autoimmune myositis. In this case report we present a 39 year old male patient admitted to the Bejuma District Hospital in October of 1991, where the patient is evaluated for 21 days. Electromyography, skeletal muscle biopsies, and further lab tests were performed; posing a diagnostic impression of Polymyositis. After the analysis of these results, the patient is discharged with pharmacological treatment; however, he denies taking the medications. In March of 2007 patient is seen at the Bejuma District Hospital after complaining of respiratory distress during mild efforts, concomitantly non-productive cough and palpitations. It is concluded that the rate of cardiovascular deterioration without constant medical treatment is secondary to untreated Polymyositis.La polimiositis es una enfermedad autoinmune, caracterizada por la inflamación de los tejidos musculares. Pertenece a la familia de las miopatías inflamatorias, junto con dermatomiositis, miositis de cuerpos de inclusión y miositis autoinmune necrotizante. En este caso presentamos un paciente varón de 39 años admitido en el Hospital del Distrito de Bejuma en octubre de 1991, donde el paciente es evaluado durante 21 días. Se realizaron electromiografía, biopsias del músculo esquelético y más pruebas de laboratorio; lo que supone una impresión diagnóstica de Polimiositis. Después del análisis de estos resultados, el paciente es dado de alta con tratamiento farmacológico; sin embargo, niega tomar los medicamentos. En marzo de 2007 el paciente es visto en el Hospital del Distrito de Bejuma después de quejarse de dificultad respiratoria durante los esfuerzos suaves, concomitantemente tos no productiva y palpitaciones. Se concluye que la tasa de deterioro cardiovascular sin tratamiento médico constante es secundaria a la polimiositis no tratada

Chancellor\u27s Citations for Extraordinary Campus Leadership and Service (2014)

The Chancellor’s Citations for Extraordinary Campus Leadership and Service recognize graduating students who are extraordinary campus leaders for their significant service to others

A Case of a Rectal Gastrointestinal Stromal Tumor: An Unexpected Cause of Lower Gastrointestinal Bleeding in an Immunocompromised Man

GISTs are rare, with only around 5,000 cases diagnosed annually in the United States. However, these tumors are the most common mesenchymal neoplasm in the gastrointestinal (GI) tract. 5%–15% of GISTS arise in the colon and rectum. Most GISTs are diagnosed incidentally on imaging, endoscopy, or during a surgical procedure

Fasciolíase hepática. Relato de um caso e revisão da literatura

Os autores relatam um caso bem documentado de fasciolíase hepática (FH) tratado com êxito com triclabendazole. As manifestações clínicas predominantes foram febre, eosinofilia marcante e dor abdominal. Triclabendazole foi dado em duas doses únicas orais de 10 mg/kg cada. Não houve efeitos colaterais, nem recaídas clínicas ou parasitológicas até três meses após tratamento. Baseados nesta experiência e em outros poucos dados revistos na literatura, triclabendazole poderia ser uma alternativa terapêutica válida no tratamento da fasciolíase humana.A well documented case of hepatic fascioliasis (HF), successfully treated with triclabendazole, is reported. Predominant clinical manifestations were fever, marked eosinophilia and abdominal pain. Triclabendazole was given as two single oral doses of 10 mg/kg each. Neither side effects nor clinical or parasitological relapses were seen after three months of follow up Based on this experience and few other similar reports in the literature, triclabendazole might be a valid therapeutical alternative in the treatment of human fascioliasis

Hepatic fascioliasis: case report and review

A well documented case of hepatic fascioliasis (HF), successfully treated with triclabendazole, is reported. Predominant clinical manifestations were fever, marked eosinophilia and abdominal pain. Triclabendazole was given as two single oral doses of 10 mg/kg each. Neither side effects nor clinical or parasitological relapses were seen after three months of follow up Based on this experience and few other similar reports in the literature, triclabendazole might be a valid therapeutical alternative in the treatment of human fascioliasis