Physical inactivity and barriers to physical activity among Type-2 diabetics in Kumasi, Ghana.

Background: Although the benefits of physical activity (PA) in diabetes management are well documented, there insufficient data on physical activity levels and barriers to physical activity among Type-2 diabetics in Ghana. This study assessed physical activity and barriers to physical activity among Type-2 diabetics at Manhyia Hospital in Kumasi, Ghana.

Methods: The study recruited 97 participants (32% men, 68% women).

Direct Endoscopic Necrosectomy With and Without Hydrogen Peroxide for Walled-off Pancreatic Necrosis: A Multicenter Comparative Study.

Introduction: Endoscopic necrosectomy has emerged as the preferred treatment modality for walled-off pancreatic necrosis. This study was designed to evaluate the safety and efficacy of direct endoscopic necrosectomy with and without hydrogen peroxide (H2O2) lavage.

Methods: Retrospective chart reviews were performed for all patients undergoing endoscopic transmural management of walled-off pancreatic necrosis at 9 major medical centers from November 2011 to August 2018.

Improving Portfolio Assessment: Addressing Challenges in Transition to Eportfolio.

Background: As health care education programs adopt electronic portfolios (eportfolios), a midwestern university baccalaureate nursing program faces challenges in transitioning from a 25-year-old paper-based system to eportfolio.

Method: Process improvements and faculty development were implemented through collaboration with the information technology (IT) department and the involvement of students as ambassadors. Pre- and posttransition surveys and portfolio benchmarks were used to evaluate the efficacy of the new eportfolio system.

EUS-guided drainage of pancreatic fluid collections using lumen apposing metal stents: An international, multicenter experience.

Introduction: Lumen apposing metal stents (LAMS) have been used increasingly for drainage of pancreatic fluid collections (PFC). We present an international, multicenter study evaluating the safety and efficacy of LAMS in PFCs.

Methods: Consecutive patients undergoing LAMS placement for PFC at 12 international centers were included (ClinicalTrials.

Corneal injury after routine gastrointestinal endoscopy with moderate sedation.

We report a case series of 4 patients who underwent routine gastrointestinal endoscopy under moderate sedation and developed corneal injuries. Although corneal abrasion has been reported as the most common ocular complication during non-ocular surgery under general anesthesia, the risk for corneal abrasion during routine endoscopic procedures using moderate sedation has not been previously reported. Symptoms reported included ocular burning, scratchy sensation, redness, and pain reported post-procedure.

Fully-covered esophageal stent migration rates in benign and malignant disease: a multicenter retrospective study.

 Stent migration is a common complication of fully-covered self-expanding metal stents (FCSEMS), but the rate of clinically relevant migration as defined by stent migration followed by reintervention via endoscopy for stent replacement is unknown. The goal of this study is to gain insight into the total migration rate and clinically relevant migration rate of different types of FCSEMS placed within benign and malignant strictures with specific attention paid to stent manufacturer, diameter, and length.  Multicenter retrospective analysis of endoscopic data from patients with FCSEMS placed within benign or malignant strictures.

Safety and efficacy of non-anesthesiologist administration of propofol sedation during esophagogastroduodenoscopy in the intensive care unit.

 Propofol sedation is an increasingly popular method of sedation for gastrointestinal endoscopic procedures. The safety and efficacy of the non-anesthesiologist administration of propofol (NAAP) sedation has been demonstrated in the ambulatory setting. However, NAAP sedation in intensive care unit (ICU) patients has not been reported.

Comparing endoscopic ultrasound-guided core biopsies of solid pancreatic and extrapancreatic lesions: a large single-operator experience with a new fine-needle biopsy needle.

Background: There has been a paradigm shift in tertiary centers from endoscopic ultrasound (EUS) fine-needle aspiration to EUS fine-needle biopsy (EUS-FNB) for tissue acquisition in solid lesions. While data exists on the use of FNB needles in solid pancreatic lesions, very few studies looked at the utility of FNB in solid extrapancreatic lesions. Our aim was to study and compare the technical success and feasibility of EUS-FNB in evaluating solid pancreatic and extrapancreatic lesions using a novel FNB needle.

Initial report of transesophageal EUS-guided intraparenchymal lung mass core biopsy: Findings and outcomes in two cases.

EUS is most commonly used to evaluate and sample lesions of the abdomen but has only been used on rare occasions to evaluate and sample lung lesions. Prior reported cases of EUS sampling of lung lesions were performed by fine-needle aspiration. We present what is believed to be the first reported cases of EUS-guided core biopsy of intraparenchymal lung lesions through two separate case reports.

Placement of lumen-apposing metal stents to drain pseudocysts and walled-off pancreatic necrosis can be safely performed on an outpatient basis: A multicenter study.

Backgrounds And Objectives: No study on the use of lumen-apposing fully covered self-expanding metal stent (LAMS) to drain pancreatic fluid collections (PFCs) has evaluated outcomes of patients in the outpatient setting. The objective of this multicenter study was to evaluate the clinical outcomes, success rate, and adverse events of the LAMS for endoscopic ultrasound (EUS)-guided transmural drainage of patients with symptomatic PFCs on an inpatient versus an outpatient basis.

Methods: This was a multicenter, retrospective study conducted at 4 tertiary care centers.

Unraveling endothelin-1 induced hypercontractility of human pulmonary artery smooth muscle cells from patients with pulmonary arterial hypertension.

Contraction of human pulmonary artery smooth muscle cells (HPASMC) isolated from pulmonary arterial hypertensive (PAH) and normal (non-PAH) subject lungs was determined and measured with real-time electrical impedance. Treatment of HPASMC with vasoactive peptides, endothelin-1 (ET-1) and bradykinin (BK) but not angiotensin II, induced a temporal decrease in the electrical impedance profile mirroring constrictive morphological change of the cells which typically was more robust in PAH as opposed to non-PAH cells. Inhibition with LIMKi3 and a cofilin targeted motif mimicking cell permeable peptide (MMCPP) had no effect on ET-1 induced HPASMC contraction indicating a negligible role for these actin regulatory proteins.

A multicenter evaluation of a new EUS core biopsy needle: Experience in 200 patients.

Background And Objectives: We present a multicenter study of a new endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle (Acquire, Boston Scientific, Natick, MA). The aim of the study was to analyze the needle's clinical performance when sampling solid lesions and to assess the safety of this device.

Methods: We performed a multicenter retrospective study of patients undergoing EUS-FNB during July 1-November 15, 2016.

A Multicenter comparative trial of a novel EUS-guided core biopsy needle (SharkCore) with the 22-gauge needle in patients with solid pancreatic mass lesions.

Background And Objectives: The ability to obtain adequate tissue of solid pancreatic lesions by EUS-guided remains a challenge. The aim of this study was to compare the performance characteristics and safety of EUS-FNA for evaluating solid pancreatic lesions using the standard 22-gauge needle versus a novel EUS biopsy needle.

Methods: This was a multicenter retrospective study of EUS-guided sampling of solid pancreatic lesions between 2009 and 2015.

ERCP performed through previously placed duodenal stents: a multicenter retrospective study of outcomes and adverse events.

Background And Aims: ERCP performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction.

Methods: We conducted a multicenter, retrospective study on 71 patients with combined gastric outlet and biliary obstruction who underwent ERCP through a previously placed enteral stent at 2 tertiary care centers.

A retrospective study evaluating endoscopic ultrasound-guided drainage of pancreatic fluid collections using a novel lumen-apposing metal stent on an electrocautery enhanced delivery system.

Objectives: To report the safety and clinical efficacy with the novel lumen-apposing metal stent (LAMS) with an electrocautery enhanced delivery system for the drainage of pancreatic fluid collections (PFCs).

Methods: This was a retrospective analysis of all consecutive patients with PFCs who underwent endoscopic ultrasound (EUS)-guided drainage using the LAMS with an electrocautery enhanced delivery system in 2 US centers.

Results: Thirteen patients with PFCs (69% with walled-off necrosis [WON]) underwent drainage using the study device.

Diagnostic yield and accuracy of a new cytology brush design compared to standard brush cytology for evaluation of biliary strictures.

Background: The sensitivity of brush cytology for biliary strictures has typically been low, usually 30%-60%. We compared the cellular yield and diagnostic accuracy using a new cytology brush (n = 16) versus standard biliary brushings (n = 16) in 32 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with brushings for evaluation of a biliary stricture for malignancy.

Methods: We performed retrospective chart reviews of 16 consecutive ERCPs with brushings performed for the cytologic evaluation of a biliary stricture for malignancy using the new cytology brush between January 2016 and February 2017 at our institution.

Efficacy and Safety of Digital Single-Operator Cholangioscopy for Difficult Biliary Stones.

Background & Aims: It is not clear whether digital single-operator cholangioscopy (D-SOC) with electrohydraulic and laser lithotripsy is effective in removal of difficult biliary stones. We investigated the safety and efficacy of D-SOC with electrohydraulic and laser lithotripsy in an international, multicenter study of patients with difficult biliary stones.

Methods: We performed a retrospective analysis of 407 patients (60.

Use of fully covered self-expanding metal stents for benign biliary etiologies: a large multi-center experience.

Background: Fully-covered self-expandable metal stents (FCSEMS) have been used in benign biliary diseases although reported data is limited. These devices are most commonly used to treat biliary leaks, strictures, or both. The aim of this study was to evaluate effectiveness of FCSEMS in treating benign biliary disease and recognize the associated complications.

Streptococcus pyogenes quinolinate-salvage pathway-structural and functional studies of quinolinate phosphoribosyl transferase and NH -dependent NAD synthetase.

Unlabelled: Streptococcus pyogenes, also known as Group A Strep (GAS), is an obligate human pathogen that is responsible for millions of infections and numerous deaths per year. Infection manifestations can range from simple, acute pharyngitis to more complex, necrotizing fasciitis. To date, most treatments for GAS infections involve the use of common antibiotics including tetracycline and clindamycin.

Pyloroplasty Offers Relief of Postfundoplication Gastroparesis in Patients Who Improved After Botulinum Toxin Injection.

Background: Endoscopic intrapyloric Botox (onabotulinumtoxin A; Allergan Pharmaceuticals) injections can improve postfundoplication gastroparesis, but responses are not durable. Surgical pyloroplasty may relieve gastroparetic symptoms, but patient selection criteria are poorly defined. We hypothesize that pyloroplasty provides durable improvement in patients whose symptoms improved after Botox injection.

Filling the Void: A Review of Intragastric Balloons for Obesity.

Endoscopic bariatric therapies are predicted to become much more widely used in North America for obese patients who are not candidates for bariatric surgery. Of all the endoscopic bariatric therapies, intragastric balloons (IGBs) have the greatest amount of clinical experience and published data supporting their use. Three IGBs are FDA approved and are now commercially available in the USA (Orbera, ReShape Duo, and Obalon) with others likely soon to follow.

Long-term outcomes of palliative colonic stenting versus emergency surgery for acute proximal malignant colonic obstruction: a multicenter trial.

 Long-term data are limited regarding clinical outcomes of self-expanding metal stents as an alternative for surgery in the treatment of acute proximal MBO. The aim of this study was to compare the long-term outcomes of stenting to surgery for palliation in patients with incurable obstructive CRC for lesions proximal to the splenic flexure.  Retrospective multicenter cohort study of obstructing proximal CRC patients with who underwent insertion of a SEMS (n = 69) or surgery (n = 36) from 1999 to 2014.