Parent and healthcare provider views of live varicella vaccination of pediatric solid organ transplant recipients.

Background: Live attenuated varicella vaccine (LAVV) has historically been contraindicated in children who are immunocompromised due to solid organ transplant (SOT) because of safety concerns. Recently, clinical guidelines were developed that support post-transplant varicella vaccination in selected SOT recipients based on emerging evidence of LAVV safety. This qualitative study sought to explore barriers and facilitators to implementing the new guidelines, as well as acceptability of LAVV among healthcare providers (HCPs) and parents.

Proof of concept for stereotactic body radiation therapy in the treatment of functional neuroendocrine neoplasms.

Dysregulated hormonal production remains a challenge in the management of neuroendocrine neoplasms (NEN). We report 4 cases of patients with functional NEN treated with stereotactic body radiation therapy (SBRT) to either the primary/dominant metastatic site of disease or the end organ of hormonal release. No significant toxicities were observed during or after treatment.

Impact of experience on self-assessment accuracy of clinical colonoscopy competence.

Background And Aims: Self-assessment is important for life-long learning and a recommended assessment method for endoscopy skills. Prior literature has not investigated self-assessment accuracy of colonoscopic competence in the clinical setting. This study aimed to determine the self-assessment accuracy of novice, intermediate, and experienced endoscopists.

A prospective comparison of live and video-based assessments of colonoscopy performance.

Background And Aims: Colonoscopy performance is typically assessed by a supervisor in the clinical setting. There are limitations of this approach, however, because it allows for rater bias and increases supervisor workload demand during the procedure. Video-based assessment of recorded procedures has been proposed as a complementary means by which to assess colonoscopy performance.

Reliability of EUS indices to detect inflammation in ulcerative colitis.

Background And Aims: EUS is a potentially useful modality to assess severity of inflammation in ulcerative colitis (UC). We assessed the reliability of existing EUS indices and correlated them with endoscopic and histologic scores.

Methods: Four blinded endosonographers assessed 58 endoscopic and EUS videos in triplicate, from patients with UC.

Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study.

Background: Endoscopic ultrasonography is a safe and accurate modality for evaluating and managing hepatobiliary and gastrointestinal conditions (malignant and nonmalignant); its use is increasing. The aim of this study was to describe regional trends in the use of endoscopic ultrasonography in Ontario.

Methods: We conducted a population-based retrospective cohort study using health administrative databases.

Progressive learning in endoscopy simulation training improves clinical performance: a blinded randomized trial.

Background And Aims: A structured comprehensive curriculum (SCC) that uses simulation-based training (SBT) can improve clinical colonoscopy performance. This curriculum may be enhanced through the application of progressive learning, a training strategy centered on incrementally challenging learners. We aimed to determine whether a progressive learning-based curriculum (PLC) would lead to superior clinical performance compared with an SCC.

Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study.

Self-expandable stents for obstructing colorectal cancer (CRC) offer an alternative to operative management. The objective of the study was to determine stent utilization for CRC obstruction in the province of Ontario between April 1, 2000, and March 30, 2009. Colonic stent utilization characteristics, poststent insertion health outcomes, and health care encounters were recorded.

Nocardia Septic Arthritis Complicating an Anterior Cruciate Ligament Repair.

Nocardia infection following anterior cruciate ligament (ACL) allograft reconstruction is a rare occurrence. We report a case of Nocardia infection of an allograft ACL reconstruction and septic arthritis of the knee joint due to an organism most similar to the novel Nocardia species Nocardia aobensis.

Impact of a simulation training curriculum on technical and nontechnical skills in colonoscopy: a randomized trial.

Background: GI endoscopy simulation-based training augments early clinical performance; however, the optimal manner by which to deliver training is unknown.

Objective: We aimed to validate a simulation-based structured comprehensive curriculum (SCC) designed to teach technical, cognitive, and integrative competencies in colonoscopy.

Design: Single-blinded, randomized, controlled trial.

Gastrointestinal Endoscopy Competency Assessment Tool: reliability and validity evidence.

Background: Rigorously developed and validated direct observational assessment tools are required to support competency-based colonoscopy training to facilitate skill acquisition, optimize learning, and ensure readiness for unsupervised practice.

Objective: To examine reliability and validity evidence of the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT) for colonoscopy for use within the clinical setting.

Design: Prospective, observational, multicenter validation study.

Surgical residents' perceptions on learning gastrointestinal endoscopy: more hours and more standardization wanted.

Objective: Gastrointestinal endoscopy is a complex task that involves an interaction of cognitive and manual skills. There is no consensus on the optimal way to teach endoscopy. We sought to evaluate our formal endoscopy curriculum for general surgery trainees to improve the effectiveness and quality of the endoscopy teaching in this program.

Decreasing mortality from acute biliary diseases that require endoscopic retrograde cholangiopancreatography: a nationwide cohort study.

Background & Aims: The management of acute biliary diseases often involves endoscopic retrograde cholangiopancreatography (ERCP), but it is not clear whether this technique reduces mortality. We investigated whether mortality from acute biliary diseases that require ERCP has been reduced over time and explored factors associated with mortality.

Methods: We conducted a cohort study using the Nationwide Inpatient Sample (1998-2008).

A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer.

Background: Accurate preoperative staging is important in determining the appropriate treatment of gastric cancer. Recently, endoscopic ultrasound (EUS) has been introduced as a staging modality. However, reported test characteristics for EUS in gastric cancer vary.

How well is Helicobacter pylori treated in usual practice?

Background: Helicobacter pylori is a WHO class I carcinogen also associated with nonmalignant gastrointestinal diseases. Effective treatment exists, and all persons infected with H pylori should receive treatment. However, data regarding the rates of treatment prescription in clinical practice are lacking.

EUS is still superior to multidetector computerized tomography for detection of pancreatic neuroendocrine tumors.

Background: The role of EUS for detection of pancreatic neuroendocrine tumors (PNETs) is not clearly defined in institutions that use multidetector CT for pancreatic imaging.

Objective: The aims of this study were to (1) compare the detection rates of EUS and CT by type and size of PNET and calculate the incremental benefit of EUS over CT, (2) evaluate the CT detection rate for PNETs adjusted for improved CT technology over time, and (3) determine the factors associated with CT-negative PNETs.

Design: Retrospective single-center cohort study.

Enhanced diagnostic yield with prolonged small bowel transit time during capsule endoscopy.

Background: The effect of small bowel transit time (SBTT) on diagnostic yield during capsule endoscopy (CE) has not been previously evaluated. Our study aim was to assess the effect of SBTT on the likelihood of detecting intestinal pathology during CE.

Methods: We reviewed collected data on CE studies performed at Johns Hopkins Hospital from January 2006 to June 2007.

Endoscopic cryotherapy for the management of gastric antral vascular ectasia.

Background: Gastric antral vascular ectasia (GAVE) is an uncommon but clinically significant cause of chronic GI bleeding.

Objective: To assess the efficacy and safety of cryotherapy for endoscopic treatment of GAVE.

Design: Patients received 3 sessions of endoscopic cryotherapy at 3-week to 6-week intervals and had a follow-up endoscopy 4 weeks thereafter.

Performance characteristics of the suspected blood indicator feature in capsule endoscopy according to indication for study.

Background & Aims: The suspected blood indicator (SBI) feature of wireless capsule endoscopy (WCE) was developed for rapid screening of intestinal lesions with bleeding potential. Our aim was to assess the accuracy and performance characteristics of the SBI according to the indications for study in a large cohort of patients.

Methods: We reviewed collected data on all WCE studies performed at Johns Hopkins Hospital from January 2006 to June 2007.

Efficiency of an endoscopy suite in a teaching hospital: delays, prolonged procedures, and hospital waiting times.

Background: Increased demand for screening colonoscopy necessitates improved efficiency in endoscopy units, especially more efficient use of existing resources. The purpose of this study was to assess the efficiency of the endoscopy unit of a large tertiary care teaching hospital.

Objective: To assess the efficiency of the endoscopy unit in a large tertiary care teaching hospital.