Endoscopic submucosal dissection (ESD) of superficial non-ampullary duodenal epithelial tumors (SNADETs) is associated with a high rate of en bloc resection and low rate of recurrence. However, in ...the United States, SNADETs are predominantly managed using endoscopic mucosal resection (EMR) or surgery because the feasibility and safety of duodenal ESD have not yet been established. In this study, we analyzed the outcomes of duodenal ESD for SNADETs. This single-center retrospective study reviewed the data of patients who underwent ESD for SNADETs between June 2018 and August 2023. Baseline patient characteristics, histopathology of the resected lesions, adverse events, and recurrence rates were evaluated. The primary outcome measures were en bloc resection, complications, and recurrence rate. Thirty ESD procedures were performed on 24 patients. All 30 lesions were adenomas, with no cancerous lesions. The en bloc resection rate and R0 resection rates were both 53%. There were no cases of procedure-associated perforation. Post-ESD bleeding was observed in six cases. No ESD-related mortality was observed. The recurrence rate was 14% in 1 year follow up, and 28% the during all follow-up period. ESD is a safe option for SNADET in the United States; however further comparative studies are necessary to determine the optimal procedure for North American populations.
Endo-hepatology: An emerging field Hogan, Daniel E; Ma, Michael; Kadosh, David ...
World journal of gastrointestinal endoscopy,
8/2021, Letnik:
13, Številka:
8
Journal Article
Odprti dostop
Gastroenterologists have long been spearheading the care of patients with various forms of liver disease. The diagnosis and management of liver disease has traditionally been a combination of ...clinical, laboratory, and imaging findings coupled with percutaneous and intravascular procedures with endoscopy largely limited to screening for and therapy of esophageal and gastric varices. As the applications of diagnostic and therapeutic endoscopic ultrasound (EUS) have evolved, it has found a particular niche within hepatology now coined endo-hepatology. Here we discuss several EUS-guided procedures such as liver biopsy, shear wave elastography, direct portal pressure measurement, paracentesis, as well as EUS-guided therapies for variceal hemorrhage.
To improve patients' adherence to continuous positive airway pressure (CPAP) therapy, this study aimed to clarify whether machine learning-based data analysis can identify the factors related to poor ...CPAP adherence (i.e., CPAP usage that does not reach four hours per day for five days a week). We developed a CPAP adherence prediction model using logistic regression and learn-to-rank machine learning with a pairwise approach. We then investigated adherence prediction performance targeting a 12-week period and the top ten factors correlating to poor CPAP adherence. The CPAP logs of 219 patients with obstructive sleep apnea (OSA) obtained from clinical treatment at Kyoto University Hospital were used. The highest adherence prediction accuracy obtained was an F1 score of 0.864. Out of the top ten factors obtained with the highest prediction accuracy, four were consistent with already-known clinical knowledge. The factors for better CPAP adherence indicate that air leakage should be avoided, mask pressure should be kept constant, and CPAP usage duration should be longer and kept constant. The results indicate that machine learning is an adequate method for investigating factors related to poor CPAP adherence.
PDF
