80 results match your criteria: "Montreal University Hospital Center (CHUM)[Affiliation]"

Background: Efforts to improve colonoscopy have recently focused on improving adenoma detection through individual interventions. We evaluated an optimized computer-assisted technique (CADopt) versus standard colonoscopy.

Methods: A prospective randomized controlled trial was conducted enrolling adults (45-80 years) undergoing elective colonoscopy.

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Article Synopsis
  • The study focuses on developing guidelines for the safe use of fluoroscopy in gastrointestinal endoscopy, balancing its benefits with concerns about radiation exposure to patients and healthcare workers.
  • A modified Delphi method was used, involving three rounds of surveys with 46 experts, resulting in 43 proposed statements, of which 31 achieved consensus and were prioritized across various categories such as Patient Safety and Staff Safety.
  • The final consensus statements highlight the importance of education and safety measures, with a significant majority rated as high priority, aiming to enhance safety culture in healthcare settings while utilizing fluoroscopy.
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Gastroenterology

December 2024

Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada.

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Accuracy of Computer-aided Diagnosis in Colonoscopy Varies According to Polyp Location: A Systematic Review and Meta-analysis.

Clin Gastroenterol Hepatol

August 2024

IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Article Synopsis
  • - The study investigates how the location of colorectal polyps (proximal vs. distal colon) affects the performance of computer-aided diagnosis (CADx) in identifying neoplastic and non-neoplastic polyps during colonoscopies for polyps sized 5 mm or smaller.
  • - It analyzes data from 11 studies involving 7,782 polyps, showing that CADx has lower specificity and accuracy in the proximal colon compared to the distal colon, while sensitivity is similar between both locations.
  • - The conclusion highlights that while CADx works well for distal polyps, its inadequate performance in the proximal colon means it should not currently be used for those lesions until improved systems are created.
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Gastroenterology

December 2024

Division of Gastroenterology, Montreal University Hospital Center (CHUM), Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada.

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Article Synopsis
  • - Significant advances in managing large laterally spreading tumors (LSTs) in colorectal polyps exist, but management practices vary globally, prompting the need for an international consensus.
  • - A Delphi study involving 43 experts from 18 countries led to 42 statements reaching consensus regarding training, evaluation, resection techniques, and post-resection care for LSTs.
  • - The resulting expert consensus aims to standardize practices and provide clear guidance for evaluating, resecting, and following up on LSTs worldwide.
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Background: The virtual scale endoscope (VSE) helps endoscopists measure colorectal polyp size more accurately compared to visual assessment (VA). However, previous studies were not adequately powered to evaluate the sizing of polyps at clinically relevant size thresholds and relative accuracy for size subgroups.

Methods: We created 64 artificial polyps of varied sizes and Paris class morphology, randomly assigned 1:1 to be measured (383 total measurement datapoints with VSE and VA by 6 endoscopists blinded to true size) in a colon model.

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Article Synopsis
  • Accurate polyp size estimation is important for clinical decisions, and a new laser-based virtual scale endoscope (VSE) aims to improve measurement accuracy during colonoscopy compared to traditional visual assessment (VA) methods.
  • In a study with 10 expert endoscopists reviewing video sequences of 90 polyps, VSE showed a relative accuracy of 75.1%, outperforming VA at 65.0% and snare-based estimation at 62.0%.
  • The VSE significantly reduced errors in classifying smaller polyps as larger and vice versa, indicating it is more effective than VA or snare methods for accurate size estimation.
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This comprehensive review delves into the multifaceted aspects of ERK signaling and the intricate mechanisms underlying distinct cellular fates. ERK1 and ERK2 (ERK) govern proliferation, transformation, epithelial-mesenchymal transition, differentiation, senescence, or cell death, contingent upon activation strength, duration, and context. The biochemical mechanisms underlying these outcomes are inadequately understood, shaped by signaling feedback and the spatial localization of ERK activation.

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Introduction: This study aimed to compare the accuracy of polyp size measurements using a virtual scale endoscope (VSE) with an integrated laser-based adaptive scale function and visual assessment (VA) during colonoscopies.

Methods: We conducted a single-blinded, prospective randomized controlled trial. Eligible patients (aged 45-80 years) undergoing screening, surveillance, or diagnostic colonoscopies were randomly assigned (1:1) into 2 groups.

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Meeting the environmental challenges of endoscopy: a pathway from strategy to implementation.

Gastrointest Endosc

December 2023

Department of Gastroenterology, VA Medical Center, White River Junction, Vermont, USA; Department of Gastroenterology, VA Medical Center, White River Junction, Vermont; Dartmouth Hitchcock Medical Center, New Hampshire, USA.

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Introduction: Serrated lesions (SLs) including traditional serrated adenomas (TSA), large hyperplastic polyps (HP) and sessile serrated lesions (SSLs) are associated with high incomplete resection rates. Margin ablation combined with EMR (EMR-T) has become routine to reduce local recurrence while cold snare polypectomy (CSP) is becoming recognized as equally effective for large SLs. Our aim was to evaluate local recurrence rates (LRR) and the use of margin ablation in preventing recurrence in a retrospective cohort study.

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Introduction: Polyp size determination plays an important role in endoscopic decision making and follow-up determination. However, there is a lack of knowledge of endoscopist accuracy for polyp sizing and efficacy of available tools for size measurement. Our aim was to compare the accuracy of visual assessment, snare, forceps, and virtual scale endoscope (VSE) in estimating polyp size among a diverse group of endoscopists.

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Nurses' communication regarding the sexual health of women with gynecologic cancer is suboptimal and may be attributed to their lack of sexual health training and knowledge. Our study aims to document the learning experience, impacts, and feasibility of an online educational intervention activity between oncology nurses and a simulated participant on communication with patients regarding oncological sexual health. Using a qualitative approach, we conducted a feasibility study, which included 11 oncology nurses, and performed semi-structured individual interviews after our simulation exercise.

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Incomplete resection of 4- to 20-mm colorectal polyps occur frequently (> 10 %), putting patients at risk for post-colonoscopy colorectal cancer. We hypothesized that routine use of wide-field cold snare resection with submucosal injection (CSP-SI) might reduce incomplete resection rates (IRRs). Patients aged 45 to 80 years undergoing elective colonoscopies were enrolled in a prospective clinical study.

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Endolymphatic Duct Blockage as a Surgical Treatment Option for Ménière's Disease.

J Vis Exp

April 2023

Department of Otorhinolaryngology, Haga Hospital; Department of Otorhinolaryngology, Leiden University Medical Centre; Department of Otorhinolaryngology, Antwerp University Hospital.

Article Synopsis
  • - Endolymphatic duct blockage is a new treatment for Ménière's disease designed to reduce vertigo attacks while preserving hearing and balance.
  • - The surgical process involves identifying and blocking the endolymphatic duct with a titanium clip after a mastoidectomy, with confirmation through CT scans.
  • - Preliminary results show a 96.5% rate of patients being free from vertigo 2 years post-surgery, but more research is still needed to validate these findings.
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Background And Aims: Serrated lesions (SL) have been associated with significant risks of developing colorectal cancer (CRC). Data on synchronous findings after SL detection during colonoscopy is limited. Study aim was to evaluate the rate of synchronous advanced neoplasia (S-AN) and synchronous CRC (S-CRC) in colonoscopies where SLs were detected.

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Proprioceptive cervicogenic dizziness (PCGD) is the most prevalent subcategory of cervicogenic dizziness. There is considerable confusion regarding this clinical syndrome's differential diagnosis, evaluation, and treatment strategy. Our objectives were to conduct a systematic search to map out characteristics of the literature and of potential subpopulations of PCGD, and to classify accordingly the knowledge contained in the literature regarding interventions, outcomes and diagnosis.

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Accurate polyp size measurement is important for guideline conforming choice of polypectomy techniques and subsequent surveillance interval assignments. Some endoscopic tools (biopsy forceps [BF] or endoscopic rulers [ER]) exist to help with visual size estimation. A virtual scale endoscope (VSE) has been developed that allows superimposing a virtual measurement scale during live endoscopies.

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BACKGROUND : Serrated lesions are potential colorectal cancer precursors. This study evaluated the presence of total metachronous advanced neoplasia (T-MAN) at follow-up in patients with index serrated lesions compared with a matched cohort without serrated lesions. METHODS : Patients aged 45-74 years with serrated lesions were matched 2:1 by sex, age, synchronous polyps, and timing of index colonoscopy, to patients without serrated lesions.

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