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Effect of music on patients undergoing outpatient colonoscopy

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World Journal of Gastroenterology 2006年第45期12卷 7309-7312页

作者： matthew l bechtold Rodney A Perez Srinivas R Puli John B Marshall Division of Gastroenterology University of Missouri School of Medicine Columbia Missouri United States

AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. METHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. RESUlTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. CONClUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

关键词： Colonoscopy Gastrointestinal endoscopy Music Music therapy Relaxation music

Bravo (wireless) ambulatory esophageal pH monitoring: How do day 1 and day 2 results compare?

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World Journal of Gastroenterology 2007年第30期13卷 4091-4095页

作者： matthew l bechtold Jason-Scott l Holly Klaus Thaler John B Marshall Division of Gastroenterology University of Missouri Hospital and Clinics Columbia MO 65212 United States General Surgery University of Missouri Hospital and Clinics Columbia MO 65212 United States

AIM： To investigate if differences exist for patients＇ gastroesophageal reflux as measured by the Bravo ambulatory esophageal pH system between d 1 and d 2.METHODS： A retrospective study of 27 consecutive adult patients who underwent Bravo esophageal pH monitoring was performed. Patients underwent EGD under Ⅳ conscious sedation prior to Bravo placement. Acid reflux variables and symptom scores for d 1 were compared to d 2.RESUlTS： The mean doses of fentanyl and midazolam were 90.4 μg and 7.2 mg, respectively. D 1 results were significantly more elevated than d 2 with respect to total time pH 〈 4, upright position reflux, and mean number of long refluxes. No statistical difference was noted between the two days for supine position reflux, number of refluxes, duration of longest reflux, episodes of heartburn, and symptom score.CONClUSION： Patients undergoing Bravo esophageal pH monitoring in association with EGD and moderate conscious sedation experience significantly more acid reflux on d i compared to d 2. The Ⅳ sedation may be responsible for the increased reflux on d 1. Performed this way, 48-h Bravo results may not be entirely representative of the patients＇ true GE reflux profile.

关键词： Esophageal pH monitoring Bravo Gastroeso- phageal reflux disease Reflux pH testing

How good is endoscopic ultrasound for TNM staging of gastric cancers? A meta-analysis and systematic review

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World Journal of Gastroenterology 2008年第25期14卷 4011-4019页

作者： Srinivas Reddy Puli Jyotsna Batapati Krishna Reddy matthew l bechtold Mainor R Antillon Jamal A Ibdah Division of Gastroenterology and Hepatology University of Missouri-Columbia

AIM: To evaluate the accuracy of endoscopic ultrasound (EUS) for staging of gastric cancers. METHODS: Only EUS studies confirmed by surgery were selected. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Articles were searched in Medline, Pubmed, Ovid journals, Cumulative index for nursing & allied health literature, International pharmaceutical abstracts, old Medline, Medline nonindexed citations, and Cochrane control trial registry. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. 2 × 2 tables were constructed with the data extracted from each study. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specifi city, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fi xed effects model) and DerSimonian laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. RESUlTS: Initial search identified 1620 reference articles and of these, 376 relevant articles were selected and reviewed. Twenty-two studies (n = 1896) which met the inclusion criteria were included in this analysis. Pooled sensitivity of T1 was 88.1% (95% CI: 84.5-91.1) and T2 was 82.3% (95% CI: 78.2-86.0). For T3, pooled sensitivity was 89.7% (95% CI: 87.1-92.0). T4 hada pooled sensitivity of 99.2% (95% CI: 97.1-99.9). For nodal staging, the pooled sensitivity for N1 was 58.2% (95% CI: 53.5-62.8) and N2 was 64.9% (95% CI: 60.8-68.8). Pooled sensitivity to diagnose distant metastasis was 73.2% (95% CI: 63.2-81.7). The P for chi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. CONClUSION: EUS results are more accurate with advanced disease than early disease. If EUS diagnoses advanced disease, such as T4 disease, the patient is 500 times more likely to h

关键词： Gastric cancer Staging Meta-analysis Endoscopic ultrasound

Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis

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World Journal of Gastroenterology 2016年第43期22卷 9642-9649页

作者： matthew Chin William Karnes M Mazen Jamal John G lee Robert lee Jason Samarasena matthew l bechtold Douglas l Nguyen Division of Gastroenterology and Hepatology University of California Irvine Division of Gastroenterology Long Beach Veterans Affairs Health System Division of Gastroenterology University of Missouri Health

AIM To perform meta-analysis of the use of Endocuff during average risk screening *** 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 l 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 *** 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.

关键词： Colonoscopy Endocuff Adenoma detection

Staging accuracy of esophageal cancer by endoscopic ultrasound:A meta-analysis and systematic review

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World Journal of Gastroenterology 2008年第10期14卷 1479-1490页

作者： Srinivas R Puli Jyotsna BK Reddy matthew l bechtold Daphne Antillon Jamal A Ibdah Mainor R Antillon Division of Gastroenterology and Hepatology University of Missouri-Columbia Columbia Missouri 65212 United States

AIM: To evaluate the accuracy of endoscopic ultrasound (EUS) in the staging of esophageal cancer. METHODS: Only EUS studies confirmed by surgery were selected. Articles were searched in Medline and Pubmed. Two reviewers independently searched and extracted data. Meta-analysis of the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fixed effects model) and DerSimonian laird method (random effects model). The heterogeneity of studies was tested using Cochran’s Q test based upon inverse variance weights. RESUlTS: Forty-nine studies (n = 2558) which met the inclusion criteria were included in this analysis. Pooled sensitivity and specificity of EUS to diagnose T1 was 81.6% (95% CI: 77.8-84.9) and 99.4% (95% CI: 99.0-99.7), respectively. To diagnose T4, EUS had a pooled sensitivity of 92.4% (95% CI: 89.2-95.0) and specificity of 97.4% (95% CI: 96.6-98.0). With Fine Needle Aspiration (FNA), sensitivity of EUS to diagnose N stage improved from 84.7% (95% CI: 82.9-86.4) to 96.7% (95% CI: 92.4-98.9). The P value for the χ2 test of heterogeneity for all pooled estimates was > 0.10. CONClUSION: EUS has excellent sensitivity and specificity in accurately diagnosing the TN stage of esophageal cancer. EUS performs better with advanced (T4) than early (T1) disease. FNA substantially improves the sensitivity and specificity of EUS in evaluating N stage disease. EUS should be strongly considered for staging esophageal cancer.

关键词： Esophageal cancer Cancer staging Endoscopic ultrasound, TNM staging, Diagnostic accuracy

Endoscopic ultrasound:It’s accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

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World Journal of Gastroenterology 2008年第19期14卷 3028-3037页

作者： Srinivas R Puli Jyotsna Batapati Krishna Reddy matthew l bechtold Jamal A Ibdah Daphne Antillon Shailender Singh Mojtaba Olyaee Mainor R Antillon Division of Gastroenterology and Hepatology University of Missouri- Columbia Division of Gastroenterology and Hepatology University of Kansas School of Medicine

AIM:To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. METHODS:Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian laird method (random effects model). The heterogeneity of studies was tested using Cochran’s Q test based upon inverse variance weights. RESUlTS:Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI:82.9-86.4) to 88.0% (95% CI:85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI:83.2-85.9) to 96.4% (95% CI:95.3-97.4). The P forchi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. CONClUSION:EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.

关键词： Endoscopic ultrasound EUS-fine needleaspiration Mediastinal lymphadenopathy

Effect of precut sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis:A systematic review and meta-analysis

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World Journal of Gastroenterology 2014年第14期20卷 4093-4101页

作者： Abhishek Choudhary Jessica Winn Sameer Siddique Murtaza Arif Zainab Arif Ghassan M Hammoud Srinivas R Puli Jamal A Ibdah matthew l bechtold Division of Gastroenterology Department of Internal MedicineUniversity of Missouri-Columbia Division of Gastroenterology and Hepatology University of IllinoisPeoria CampusOSF Saint Francis Medical CenterPeoria

AIM: To conduct a systemic review and meta-analysis to investigate the role of early precut technique. Multiple randomized controlled trails (RCTs) have reported conflicting results of the early precut sphincterotomy.

关键词： Early precut Endoscopic retrograde cholangiopancreatography cannulation Post-endoscopic retrograde cholangiopancreatography pancreatitis Randomized controlled trials Meta-analysis

Cap-assisted endoscopy for esophageal foreign bodies:A metaanalysis

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World Journal of Meta-Analysis 2023年第1期11卷 38-46页

作者： Zahid Ijaz Tarar Umer Farooq matthew l bechtold Yezaz A Ghouri Department of Internal Medicine University of MissouriColumbiaMO 65212United States Department of Medicine Loyola UniversityChicagoIL 60153United States Department of Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Department of Internal Medicine Division of Gastroenterology and HepatologyUniversity of MissouriColumbiaMO 65212United States

BACKGROUND Esophageal foreign bodies are common around the *** approaches,such as cap-assisted endoscopy,have been introduced as an alternative to conventional ***,we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign *** To investigated the effectiveness of cap-assisted endoscopy with conventional *** An extensive literature search was performed(December 2021).For esophageal foreign body removal,cap-assisted endoscopy was compared to conventional endoscopy for procedure time,technical success of the procedure,time of foreign body retrieval,en bloc removal,and adverse event rate using odds ratio and mean *** Six studies met the inclusion criteria(n=1305).Higher odds of technical success(P=0.002)and en bloc removal(Plower odds of adverse events(P=0.02)and foreign body removal time(Pl *** For esophageal foreign bodies,the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.

关键词： Esophageal foreign body Food bolus Endoscopy Snares Forceps Assisted devices Capassisted endoscopy

Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: A systematic review and meta analysis

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World Journal of Gastroenterology 2013年第23期19卷 3678-3684页

作者： Srinivas R Puli Nikhil Kalva matthew l bechtold Smitha R Pamulaparthy Micheal D Cashman Norman C Estes Richard H Pearl Fritz-Henry Volmar Sonu Dillon Michael F Shekleton David Forcione Division of Gastroenterology and Hepatology University of Illinois Peoria Campus OSF Saint Francis Medical CenterPeoria IL 61637 United States Department of Internal Medicine University of Illinois Peoria Campus OSF Saint Francis Medical CenterPeoria IL 61637 United States Division of Gastroenterology and Hepatology University of Missouri-ColumbiaColumbia MS 65212 United States Department of Surgery University of Illinois Peoria Campus OSF Saint Francis Medical CenterPeoria IL 61637 United States Interventional Endoscopy Services Gastrointestinal Unit Massachusetts General Hospital Harvard Medical SchoolBoston MA 02114 United States

AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting ***: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model). RESUlTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10. CONClUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.

关键词： Endoscopic ultrasound Ultrasound Endosonography Pancreatic mass Neuroendocrine tumors Sensitivity Specificity Positive predictive value Negative predictive value