Methods: Training in ergonomics is either fragmented or lacking in most GI programs, with less than 25% of trainees receiving formal education in ergonomics in the United States. Conclusion: Our data ...show a positive perception of trainees of a practical, reproducible, and low-cost curriculum for endoscopy incorporated during GI fellowship. See PDFTable 1. (a and b) Baseline characteristics, pre- and post-test evaluation of fellows (a) Baseline Characteristics (n = 23) Age 33.1 ± 4.7 Female, % (n) 41 (9) Post-Graduate training year, % (n) PGY4 21.7 (5) PGY5 21.7 (5) PGY6 26.1 (6) PGY7 30.4 (7) Right-handed, % (n) 91 (21) Trainees who have sustained an ERI, % (n) 13.6 (3) Trainees confident in being able to recognize signs and symptoms of ERI, % (n) 63.6 (14) Trainees who had reviewed material regarding ergonomics in endoscopy prior to this curriculum 39.1 (9) Sources of knowledge for these trainees, % (n) Journal articles 55.5 (5) External videos/grand rounds 44.4 (4) (b) Post-Curriculum Evaluation (n =13) Self-rated current practice of ergonomics median, (IQR) 4 (2.5, 4) Most impactful portion of the ergonomics curriculum, % (n) Didactics lecture 38.5 (5) Interactive session with OT 53.8 (7) Free accessories 7.7 (1) Trainees who think a repeat review of this curriculum is needed, % (n) 100 (13) Semi-annually 53.8 (7) Annually 46.2 (6) Abbreviations: ERI: endoscopy-related injury; OT: occupational therapy; IQR: inter-quartile range.
S3634 Menetrier Disease: A Case Report Ghusn, Wissam; Gala, Khushboo S.; Acosta, Andres
The American journal of gastroenterology,
10/2022, Letnik:
117, Številka:
10S
Journal Article
INTRODUCTION: Limited data exist evaluating antiobesity medications (AOM) in patients with inflammatory bowel disease (IBD). METHODS: We performed a case-control study evaluating the effectiveness ...and safety of AOM in patients with IBD with obesity, matched to non-IBD controls. RESULTS: After 12 months, the case (n = 36) and control (n = 36) groups achieved similar percent total body weight loss of −6.9 ± 8.3 and −8.1 ± 7.0 ( P = 0.30), respectively. Side effect profiles were similar between groups. Seven patients experienced an IBD flare, all managed medically. DISCUSSION: AOM use in patients with IBD demonstrated similar effectiveness and safety when compared with that observed in the non-IBD population.
Inadequate bowel preparation can result in decreased diagnostic accuracy and therapeutic safety of colonoscopy for colon cancer screening. The Boston Bowel Preparation Scale (BBPS) has been used to ...assess the quality of bowel preparation. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are commonly used medications for diabetes mellitus and obesity that are known to delay gastrointestinal motility. We hypothesized that the use of GLP-1RA would be associated with decreased quality of bowel preparation.
We performed a retrospective cohort study of patients who underwent screening or surveillance colonoscopy at a large academic medical center between December 2021 and December 2022. We included patients taking any GLP-1RA for diabetes or obesity during colonoscopy defined as our cases, and patients who were prescribed GLP-1RA at one point but not within 3 months of colonoscopy defined as our controls. We excluded patients on any promotility or antimotility agents and those without BBPS recorded on their procedure report. Independent t test assessed statistical differences in the case and control groups to compare the quality of bowel preparation for continuous variables, and the χ 2 test was used for categorical variables. Multivariate linear regression including diabetes as a covariate was also performed for continuous variables, and multivariate logistic regression was performed for categorical variables.
A total of 446 patients were included in the study, comprising 265 (59%) cases and 181 controls (41%). There were no statistically significant differences between groups at baseline except for the diagnosis of diabetes ( P = 0.001) with a higher proportion of patients with diabetes in the cases. The mean BBPS was significantly higher in controls (7.0 ± 1.9 vs 7.5 ± 2.4, P = 0.046) when controlling for diabetes. The percentage of patients with a total BBPS score of <5 was significantly higher in cases (15.5% vs 6.6%, P = 0.01). The proportion of patients who required a repeat colonoscopy due to poor bowel preparation was also significantly higher in cases (18.9% vs 11.1%, P = 0.041).
The use of GLP-1RA was associated with a statistically significantly lower quality of bowel preparation, with additional clinical significance given a notable difference in the need for a repeat colonoscopy. It will be essential to understand the cumulative effect of medications that may delay gastric emptying on the quality of bowel preparation to better understand the appropriate measures and counseling that need to be taken before undergoing outpatient colonoscopies.
