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3. Su1628 INDEX CHOLECYSTECTOMY DURING BILIARY ACUTE PANCREATITIS IN CIRRHOTICS: LARGE COHORT STUDY

Author

Pedro Palacios Argueta, John Rodriguez, Miguel Salazar, C. Roberto Simons-Linares, Brittany Mitchell, William D. Carey, Andrew A. Young, John J. Vargo, Tyler Stevens, and Prabhleen Chahal

Subjects
medicine.medical_specialty, Index (economics), Hepatology, business.industry, medicine.medical_treatment, Internal medicine, Gastroenterology, Biliary acute pancreatitis, Medicine, Cholecystectomy, business, Large cohort
Published
2020
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4. Su1636 VACCINE-PREVENTABLE DISEASES ADMISSION RATES AND HEALTHCARE RELATED OUTCOMES IN PATIENTS WITH CIRRHOSIS

Author

Bashar M. Attar, Miguel Salazar, Pedro Palacios Argueta, Prabhleen Chahal, John J. Vargo, William D. Carey, and C. Roberto Simons-Linares

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Health care, Gastroenterology, medicine, In patient, Vaccine-preventable diseases, business, Intensive care medicine, medicine.disease
Published
2020
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5. Tu1579 THIRTY-DAY READMISSION AMONG PATIENTS WITH ALCOHOLIC ACUTE PANCREATITIS: CAUSES, PREDICTORS, EFFECTS ON OUTCOMES AND HEALTHCARE

Author

Juan E. Corral, C. Roberto Simons-Linares, Pedro Palacios Argueta, Miguel Salazar, Frank Lukens, John J. Vargo, and Prabhleen Chahal

Subjects
medicine.medical_specialty, Hepatology, business.industry, THIRTY-DAY, Internal medicine, Health care, Gastroenterology, medicine, Acute pancreatitis, business, medicine.disease
Published
2020
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7. Tu2041 OUTCOMES OF ACUTE GALLSTONE PANCREATITIS IN PATIENTS WITH CIRRHOSIS: DO THEY GET SAME-ADMISSION CHOLECYSTECTOMY?

Author

William D. Carey, John Rodriguez, John J. Vargo, Miguel Salazar, C. Roberto Simons-Linares, Prabhleen Chahal, Tyler Stevens, and Pedro Palacios Argueta

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, medicine.medical_treatment, Gastroenterology, medicine.disease, Internal medicine, medicine, Pancreatitis, Cholecystectomy, In patient, business
Published
2020
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11. 181 OUTCOMES OF ACUTE GALLSTONE PANCREATITIS IN BARIATRIC SURGERY PATIENTS: DOES SAME ADMISSION CHOLECYSTECTOMY IMPROVE OUTCOMES?

Author

John Rodriguez, Pedro Palacios Argueta, Tyler Stevens, John J. Vargo, C. Roberto Simons-Linares, Miguel Salazar, and Prabhleen Chahal

Subjects
medicine.medical_specialty, Hepatology, business.industry, medicine.medical_treatment, Gastroenterology, Medicine, Pancreatitis, Cholecystectomy, business, medicine.disease, Surgery
Published
2020
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14. 72 PATIENTS READMITTED WITH GALLSTONE ACUTE PANCREATITIS HAVE HIGHER MORTALITY THAN THE INDEX HOSPITALIZATION: OUTCOMES AND PREDICTORS OF THIRTY-DAY READMISSIONS

Author

John Rodriguez, Juan E. Corral, John J. Vargo, Pedro Palacios Argueta, Prabhleen Chahal, C. Roberto Simons-Linares, and Miguel Salazar

Subjects
medicine.medical_specialty, Hepatology, Gallstone acute pancreatitis, business.industry, Internal medicine, THIRTY-DAY, Gastroenterology, medicine, business, Index hospitalization
Published
2020
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15. 798 EARLY CHOLECYSTECTOMY DURING INDEX ADMISSION FOR GALLSTONE ACUTE PANCREATITIS LOWERS 30-DAY READMISSION RATES AND IMPROVES OUTCOMES

Author

John Rodriguez, Miguel Salazar, Tyler Stevens, C. Roberto Simons-Linares, Prabhleen Chahal, Pedro Palacios Argueta, and John J. Vargo

Subjects
medicine.medical_specialty, Index (economics), Hepatology, Gallstone acute pancreatitis, business.industry, Internal medicine, medicine.medical_treatment, Gastroenterology, Medicine, Cholecystectomy, business
Published
2020
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16. 996 OUTCOMES IN PATIENTS ADMITTED WITH ACUTE MYOCARDIAL INFARCTION THAT DEVELOPED UPPER GASTROINTESTINAL BLEED AND UNDERWENT SAME ADMISSION UPPER ENDOSCOPY

Author

Pedro Palacios Argueta, Miguel Salazar, John J. Vargo, Prabhleen Chahal, Sunguk Jang, C. Roberto Simons-Linares, Amit Bhatt, and Juan E. Corral

Subjects
Upper gastrointestinal bleed, medicine.medical_specialty, Hepatology, business.industry, Upper endoscopy, Gastroenterology, Medicine, In patient, Myocardial infarction, business, medicine.disease, Surgery
Published
2020
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17. 343 DOES EARLY EGD IMPROVE MORTALITY IN HOSPITALIZED PATIENTS WITH ACUTE MYOCARDIAL INFARCTION THAT DEVELOP UPPER GASTROINTESTINAL BLEED?

Author

Amit Bhatt, Bashar M. Attar, C. Roberto Simons-Linares, Miguel Salazar, Pedro Palacios Argueta, John J. Vargo, Prabhleen Chahal, Sunguk Jang, and Frank Lukens

Subjects
Upper gastrointestinal bleed, medicine.medical_specialty, Hepatology, business.industry, Hospitalized patients, Internal medicine, Gastroenterology, medicine, Cardiology, Myocardial infarction, medicine.disease, business
Published
2020
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18. Mo1361 ANTI-TUMOR NECROSIS FACTOR THERAPY IS EQUIVALENT TO SMOKING IN INCREASING THE RISK OF PANCREATIC ADENOCARCINOMA IN CROHN'S DISEASE: FINDINGS OF A NATIONWIDE EPIDEMIOLOGICAL STUDY

Author

Miguel Regueiro, C. Roberto Simons-Linares, Carol Rouphael, Motasem Alkhayyat, Prabhleen Chahal, Emad Mansoor, Mohannad Abou Saleh, and John J. Vargo

Subjects
Oncology, medicine.medical_specialty, Crohn's disease, Anti-Tumor Necrosis Factor Therapy, Hepatology, business.industry, Internal medicine, Epidemiology, Gastroenterology, Medicine, Adenocarcinoma, business, medicine.disease
Published
2020
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21. Tu1950 OBESE MINORITIES HAVE HIGHER HOSPITALIZATION RATES FOR VACCINE PREVENTABLE DISEASES: NEED FOR VACCINATION POLICIES TARGETING RACIAL DISPARITIES?

Author

C. Roberto Simons-Linares, Pedro Palacios Argueta, Mohannad Abou Saleh, John J. Vargo, John Rodriguez, Prabhleen Chahal, Vibhu Chittajallu, Bashar M. Attar, and Miguel Salazar

Subjects
Vaccination, Hepatology, business.industry, Environmental health, Gastroenterology, Medicine, Vaccine-preventable diseases, business
Published
2020
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22. Tu2026 OUTCOMES OF HOSPITALIZATION FOR VACCINE PREVENTABLE DISEASES IN POST BARIATRIC SURGERY POPULATION

Author

John Rodriguez, Sunguk Jang, John J. Vargo, Pedro Palacios Argueta, C. Roberto Simons-Linares, Christopher C. Thompson, Miguel Salazar, and Prabhleen Chahal

Subjects
medicine.medical_specialty, Post bariatric surgery, education.field_of_study, Hepatology, business.industry, Population, Gastroenterology, medicine, Vaccine-preventable diseases, Intensive care medicine, business, education
Published
2020
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23. 794 SAFETY AND INPATIENT OUTCOMES OF ACUTE CHOLECYSTITIS IN PATIENTS WITH LIVER CIRRHOSIS: SAME ADMISSION CHOLECYSTECTOMY DOES NOT INCREASE MORTALITY

Author

John Rodriguez, Prabhleen Chahal, C. Roberto Simons-Linares, Zohaib Haque, Bashar M. Attar, Miguel Salazar, John J. Vargo, and Pedro Palacios Argueta

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, medicine.medical_treatment, Gastroenterology, medicine.disease, Internal medicine, medicine, Acute cholecystitis, Cholecystectomy, In patient, business
Published
2020
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24. Development and Validation of a Model to Determine Risk of Progression of Barrett's Esophagus to Neoplasia

Author

David Lieberman, Marco J. Bruno, Sreekar Vennalaganti, Kevin F. Kennedy, Patrick E. Young, Brooks D. Cash, Fouad J. Moawad, Richard E. Sampliner, Manon C.W. Spaander, Prashanth Vennalaganti, Prateek Sharma, Ajay Bansal, Sharad C. Mathur, Neil Gupta, John J. Vargo, Srinivas Gaddam, Gary W. Falk, Prashanthi N. Thota, Sravanthi Parasa, and Gastroenterology & Hepatology

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Databases, Factual, Esophageal Neoplasms, Biopsy, Kaplan-Meier Estimate, Adenocarcinoma, Risk Assessment, Cigarette Smoking, Decision Support Techniques, Barrett Esophagus, 03 medical and health sciences, Esophagus, Sex Factors, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Internal medicine, medicine, Humans, Longitudinal Studies, Risk factor, Survival analysis, Aged, Netherlands, Proportional Hazards Models, Hepatology, Proportional hazards model, business.industry, Incidence, Incidence (epidemiology), Hazard ratio, Gastroenterology, Reproducibility of Results, Middle Aged, medicine.disease, United States, Dysplasia, 030220 oncology & carcinogenesis, Predictive value of tests, Barrett's esophagus, Disease Progression, Female, 030211 gastroenterology & hepatology, Esophagoscopy, Neoplasm Grading, business
Abstract

Background & Aims A system is needed to determine the risk of patients with Barrett's esophagus for progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). We developed and validated a model to determine of progression to HGD or EAC in patients with BE, based on demographic data and endoscopic and histologic findings at the time of index endoscopy. Methods We performed a longitudinal study of patients with BE at 5 centers in United States and 1 center in Netherlands enrolled in the Barrett's Esophagus Study database from 1985 through 2014. Patients were excluded from the analysis if they had less than 1 year of follow up, were diagnosed with HGD or EAC within the past year, were missing baseline histologic data, or had no intestinal metaplasia. Seventy percent of the patients were used to derive the model and 30% were used for the validation study. The primary outcome was development of HGD or EAC during the follow-up period (median 5.9 years). Survival analysis was performed using the Kaplan-Meier method. We assigned a specific number of points to each BE risk factor, and point totals (scores) were used to create categories of low, intermediate, and high risk. We used Cox regression to compute hazard ratios (HR) and 95% CIs to determine associations between risk of progression and scores. Results Of 4584 patients in the database, 2697 were included in our analysis (84.1% men; 87.6% Caucasian; mean age, 55.4±20.1 years; mean body mass index, 27.9±5.5; mean length of BE, 3.7 cm±3.2). During the follow-up period, 154 patients (5.7%) developed HGD or EAC, with an annual rate of progression of 0.95%. Male sex, smoking, length of BE, and baseline-confirmed low-grade dysplasia were significantly associated with progression. Scores assigned identified patients with BE that progressed to HGD or EAC with a c-statistic of 0.76 (95% CI, 0.72–0.80) ( P P =.99), determined from the validation cohort. Conclusions We developed a scoring system (called progression of BE (PIB) score) based on male sex, smoking, length of BE, and baseline low-grade dysplasia) that identified patients with BE at low, intermediate, and high risk groups for HGD or EAC. This scoring system might be used in management of patients.

Published
2018

25. Anesthetist-Directed Sedation for Colonoscopy: A Safe Haven or Siren’s Song?

Author

Douglas K. Rex and John J. Vargo

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Sedation, Gastroenterology, Colonoscopy, medicine.disease, Siren (codec), 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, Safe haven, Medical emergency, medicine.symptom, Intensive care medicine, business
Published
2016
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26. Teach Your Children Well

Author

John J. Vargo

Subjects
Cholangiopancreatography, Endoscopic Retrograde, Medical education, Hepatology, business.industry, education, Gastroenterology, MEDLINE, digestive system diseases, Article, Endosonography, 03 medical and health sciences, 0302 clinical medicine, Text mining, 030220 oncology & carcinogenesis, Humans, Medicine, 030211 gastroenterology & hepatology, Child, business
Abstract

BACKGROUND & AIMS: It is unclear whether participation in competency-based fellowship programs for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) results in high-quality care in independent practice. We measured quality indicator (QI) adherence during the first year of independent practice among physicians who completed endoscopic training with a systematic assessment of competence. METHODS: We performed a prospective multicenter cohort study of invited participants from 62 training programs. In phase 1, 24 advanced endoscopy trainees (AETs), from 20 programs, were assessed using a validated competence assessment tool. We used a comprehensive data collection and reporting system to create learning curves using cumulative sum analysis that were shared with AETs and trainers quarterly. In phase 2, participating AETs entered data into a database pertaining to every EUS and ERCP examination during their first year of independent practice, anchored by key QIs. RESULTS: By the end of training, most AETs had achieved overall technical competence (EUS 91.7%, ERCP 73.9%) and cognitive competence (EUS 91.7%, ERCP 94.1%). In phase 2 of the study, 22 AETs (91.6%) participated and completed a median of 136 EUS examinations per AET and 116 ERCP examinations per AET. Most AETs met the performance thresholds for QIs in EUS (including 94.4% diagnostic rate of adequate samples and 83.8% diagnostic yield of malignancy in pancreatic masses) and ERCP (94.9% overall cannulation rate). CONCLUSIONS: In this prospective multicenter study, we found that although competence cannot be confirmed for all AETs at the end of training, most meet QI thresholds for EUS and ERCP at the end of their first year of independent practice. This finding affirms the effectiveness of training programs. Clinicaltrials.gov ID NCT02509416.

Published
2018
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27. Tu1417 – Acute Pancreatitis in Patients with Cystic Fibrosis

Author

Mohannad Abou Saleh, John J. Vargo, C. Roberto Simons-Linares, Prabhleen Chahal, Paul T. Kroner, Tyler Stevens, Sunguk Jang, and Amit Bhatt

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, Acute pancreatitis, In patient, medicine.disease, business, Cystic fibrosis
Published
2019
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28. Tu1662 – The Epidemiology of Gastric Cancer in the United States Between 2013 and 2018: A Population-Based Study

Author

Mohammed Z. Sheriff, Emad Mansoor, Amitabh Chak, Mohannad Abou Saleh, John J. Vargo, Amit Bhatt, C. Roberto Simons-Linares, and Vijit Chouhan

Subjects
Population based study, medicine.medical_specialty, Hepatology, business.industry, Environmental health, Epidemiology, Gastroenterology, Medicine, Cancer, business, medicine.disease
Published
2019
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30. Su1426 – Patients Taking Anti-Tumor Necrosis Factor α Medications Have Worse Acute Pancreatitis Outcomes

Author

Florian Rieder, Jean-Paul Achkar, Tyler Stevens, C. Roberto Simons-Linares, Emad Mansoor, Prabhleen Chahal, Mohannad Abou Saleh, John J. Vargo, and Michael J. Bartel

Subjects
Anti tumor necrosis factor α, medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, Acute pancreatitis, medicine.disease, business
Published
2019
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31. Sa1701 – Recurrence Rates After Endoscopic Resection of Duodenal Neuroendocrine Tumors: the Effect of Deep Histologic Margins and Endoscopic Resection Technique

Author

Firas Bahdi, Feng Li, Robert S. Butler, John J. Vargo, Pablo A. Bejarano, Amit Bhatt, Tyler Stevens, Umar Hayat, Sunguk Jang, Prabhleen Chahal, Neal Mehta, Tolga Erim, Deepa T. Patil, and Jonathan Ragheb

Subjects
medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Medicine, Endoscopic resection, Radiology, Neuroendocrine tumors, business, medicine.disease
Published
2019
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33. Mo1259 – Antegrade Deep Enteroscopy Should Be Considered in Hospitalized Patients for Overt Obscure Gastrointestinal Bleeding Without a Preceding Video Capsule Endoscopy

Author

Abhik Bhattacharya, Sunguk Jang, Adam J. Kichler, Matthew Hoscheit, and John J. Vargo

Subjects
Enteroscopy, Video capsule endoscopy, medicine.medical_specialty, Hepatology, business.industry, Hospitalized patients, Gastroenterology, Medicine, business, Surgery, Obscure gastrointestinal bleeding
Published
2019
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34. 56 – Predicting the Need for Intervention in Patients Presenting with Asymptomatic Gallstones: Construction and Validation of a Risk Stratification Tool

Author

Michael B. Rothberg, Carol A. Burke, John J. Vargo, Pooja Lal, Maged Rizk, Shashank Sarvepalli, Amit Bhatt, Niyati M. Gupta, Mounir Ibrahim, John McMichael, Gareth Morris-Stiff, and Ari Garber

Subjects
Pediatrics, medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Gallstones, medicine.disease, Asymptomatic, Intervention (counseling), Risk stratification, Medicine, In patient, medicine.symptom, business
Published
2019
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35. Sa1148 – The Majority of Patients with Confirmed Lgd in Barrett's Esophagus Progress Within the First Year of Diagnosis: Results from a Large Multicenter Be Consortium

Author

Kevin F. Kennedy, Prashanthi N. Thota, Gary W. Falk, Neil Gupta, Prateek Sharma, Harsh K. Patel, Marco J. Bruno, John J. Vargo, Abhiram Duvvuri, Patrick E. Young, Ramprasad Jegadeesan, Madhav Desai, Prashanth Vennalaganti, David A. Lieberman, Viveksandeep Thoguluva Chandrasekar, Brooks D. Cash, Manon C.W. Spaander, and Chandra S. Dasari

Subjects
medicine.medical_specialty, Hepatology, business.industry, General surgery, Barrett's esophagus, Gastroenterology, Medicine, business, medicine.disease
Published
2019
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38. Endoscopic Ultrasound Imaging Detection of Gastric Cancer in Familial Adenomatous Polyposis

Author

James M. Church, Michael Cruise, Amit Bhatt, Gautam Mankaney, John J. Vargo, Carol A. Burke, Vaibhav Wadhwa, and Prabhleen Chahal

Subjects
Endoscopic ultrasound, medicine.medical_specialty, medicine.medical_treatment, Biopsy, Fine-Needle, Adenocarcinoma, Endosonography, Familial adenomatous polyposis, 03 medical and health sciences, 0302 clinical medicine, Gastrectomy, Predictive Value of Tests, Stomach Neoplasms, Biopsy, medicine, Humans, Ultrasonography, Doppler, Color, Hepatology, medicine.diagnostic_test, business.industry, Incidence, Incidence (epidemiology), Gastroenterology, Cancer, Middle Aged, Prognosis, medicine.disease, Adenomatous Polyposis Coli, 030220 oncology & carcinogenesis, Predictive value of tests, Female, 030211 gastroenterology & hepatology, Radiology, Ultrasonography, business
Published
2017
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39. Predictors of Inadequate Bowel Preparation in 91,045 Ambulatory Patients in Open Access Endoscopy Practice

Author

Michael B. Rothberg, Amit Bhatt, Carol A. Burke, Rocio Lopez, Nazih Isseh, Maged Rizk, John J. Vargo, Umar Hayat, Ari Garber, John McMichael, and Mahmoud Isseh

Subjects
medicine.medical_specialty, Pediatrics, Hepatology, medicine.diagnostic_test, business.industry, General surgery, Ambulatory, Gastroenterology, medicine, business, Endoscopy, Inadequate bowel preparation
Published
2017
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40. Common Bile Duct Dilation after Bariatric Surgery

Author

Tyler Stevens, Ahmed Eltelbany, Andrew T. Strong, Neal Mehta, Carol A. Burke, John J. Vargo, Joesph Veniro, Rocio Lopez, Maged Rizk, Bo Hu, Adeyinka Owoyele, Matthew Kroh, Prabhleen Chahal, and Amit Bhatt

Subjects
medicine.medical_specialty, Hepatology, Common bile duct, business.industry, Gastroenterology, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Medicine, Dilation (morphology), 030211 gastroenterology & hepatology, business
Published
2017
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42. 9 - Barrett's Esophagus International Consortium Study: Detection of Post-Endoscopy Neoplastic Progression in Patients Undergoing Surveillance

Author

Neil Gupta, Sharad C. Mathur, Prashanth Vennalaganti, Richard E. Sampliner, David A. Lieberman, Prateek Sharma, Patrick E. Young, Marco J. Bruno, Fouad J. Moawad, Kevin F. Kennedy, John J. Vargo, Manon C.W. Spaander, Sravanthi Parasa, Sreekar Vennelaganti, Carlijn A. Roumans, Ajay Bansal, Srinivas Gaddam, Prashanthi N. Thota, Brooks D. Cash, and Gary W. Falk

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, medicine.disease, Endoscopy, Internal medicine, Barrett's esophagus, medicine, Neoplastic progression, In patient, business
Published
2018
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43. Sa1400 - The Triad of Diabetes Ketoacidosis, Hypertriglyceridemia and Acute Pancreatitis. How Does it Affect Mortality and Morbidity? 10-Years Analysis of the National Inpatient Sample

Author

C. Roberto Simons-Linares, Prabhleen Chahal, Sunguk Jang, Rocio Lopez, John J. Vargo, Tyler Stevens, Amit Bhatt, Pooja Lal, and Madhusudhan R. Sanaka

Subjects
Pediatrics, medicine.medical_specialty, Hepatology, business.industry, Hypertriglyceridemia, Gastroenterology, medicine.disease, Affect (psychology), Ketoacidosis, Triad (sociology), Diabetes mellitus, medicine, Acute pancreatitis, business
Published
2018
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44. Sa1422 - Long-Term Outcomes of Percutaneous Cholecystostomy Tube (Pct) Placement in High-Risk Surgical Patients with Acute Cholecystitis (Ac)

Author

Amit Bhatt, Tyler Stevens, John J. Vargo, Suha Abushamma, Sunguk Jang, A. Gill, Ram Gurajala, Prabhleen Chahal, C. Roberto Simons-Linares, Gareth Morris-Stiff, and Olapeju Olasokan

Subjects
medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Long term outcomes, Acute cholecystitis, medicine, Percutaneous cholecystostomy, Tube (fluid conveyance), business, Surgical patients, Surgery
Published
2018
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46. 900 - Clinical Outcomes of Acute Pancreatitis in Patients with Liver Cirrhosis. 10-Years Analysis of the National Inpatient Sample Database in the United States

Author

William D. Carey, C. Roberto Simons-Linares, Sunguk Jang, Rocio Lopez, Tyler Stevens, John J. Vargo, Prabhleen Chahal, Carlos Romero-Marrero, Amit Bhatt, and Madhusudhan R. Sanaka

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, Acute pancreatitis, In patient, Sample (statistics), medicine.disease, business
Published
2018
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49. Report of the Multisociety Task Force on GI Training

Author

Philip O. Katz, Lawrence S. Friedman, Michael H. Stolar, John F. Kuemmerle, John J. Vargo, Grace H. Elta, Gregory J. Gores, Lawrence J. Brandt, Darrell S. Pardi, and J. Gregory Fitz

Subjects
medicine.medical_specialty, Certification, Process (engineering), Advisory Committees, education, Guidelines as Topic, Medical Oncology, Training (civil), Endoscopy, Gastrointestinal, Maintenance of Certification, Internal medicine, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Duration (project management), Curriculum, Societies, Medical, Medical education, Education, Medical, Hepatology, Task force, business.industry, Gastroenterology, Competency-Based Education, United States, Liver Transplantation, Practice Guidelines as Topic, Education, Medical, Continuing, Psychology, business
Abstract

In summary, the task force recommends that the 4 gastroenterology/hepatology societies work with the ABIM to develop a competency-based curriculum that incorporates the Maintenance of Certification process to accommodate the need and desire for training and subsequent practice in specific areas of gastroenterology/hepatology. Given the increasing complexity of treating digestive diseases, allowing trainees the opportunity to develop enhanced ability and experience in specific disease areas or procedures will benefit patients. By developing these training pathways, training programs will need to measure the achievements of trainees in terms of specific defined competencies rather than the duration of training alone.

Published
2009
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50. Capnographic Monitoring of Respiratory Activity Improves Safety of Sedation for Endoscopic Cholangiopancreatography and Ultrasonography

Author

Mohammed A. Qadeer, Rocio Lopez, John J. Vargo, Patricia Trolli, John A. Dumot, Tyler Stevens, Mansour A. Parsi, Madhusudhan R. Sanaka, and Gregory Zuccaro

Subjects
Capnography, Endoscopic retrograde cholangiopancreatography, Hepatology, medicine.diagnostic_test, business.industry, Sedation, Gastroenterology, Apnea, respiratory tract diseases, Hypoxemia, law.invention, Endoscopy, Randomized controlled trial, law, Anesthesia, Breathing, Medicine, medicine.symptom, business
Abstract

Background & Aims The Joint Commission on the Accreditation of Healthcare Organizations recommends ventilation monitoring during procedural sedation for gastrointestinal endoscopy. We sought to determine whether intervention, based on a microstream capnography-based ventilation monitoring system that has been shown to function as an early warning system for hypoxemia, would decrease hypoxemia during endoscopy. Methods Subjects undergoing elective endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) under procedural sedation with a combination of opioid and benzodiazepine were randomly assigned to either a study arm in which the endoscopy team was blinded to capnography or an open arm in which the endoscopy team was prompted of capnographic changes. The primary end point was the occurrence of hypoxemia; secondary end points were the occurrences of severe hypoxemia, apnea, and oxygen supplementation. Results A total of 263 subjects were enrolled; 247 were analyzed for efficacy. The numbers of hypoxemic events in the blinded and open arms were 132 and 69, respectively ( P P P = .004), for apnea were 63% and 41% ( P P = .02), and for recurrent hypoxemia after oxygen supplementation were 38% and 18% ( P = .01), respectively. Conclusions Capnographic monitoring of respiratory activity improves patient safety during procedural sedation for elective ERCP/EUS by reducing the frequency of hypoxemia, severe hypoxemia, and apnea.

Published
2009
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