| 1 | Randomized, double-blinded, placebo-controlled trial evaluating simethicone pretreatment with bowel preparation during colonoscopy显示文摘BACKGROUND The presence of small air bubbles and foam are an impediment to a successful colonoscopy. They impair an endoscopist’s view and diminish the diagnostic accuracy of the study. This has been particularly noted to be of concern with the switch to lower volume polyethylene glycol (PEG) and bisacodyl combination preparation. AIM To evaluate the effect of oral simethicone addition to bowel preparation on intraluminal bubbles reduction during colonoscopy. METHODS Described is a prospective, randomized, multi-center, double-blinded, placebocontrolled study to evaluate the use of premixed simethicone formulation with split-regimen, low-volume PEG-bisacodyl combination bowel preparation for 168 outpatients undergoing screening, surveillance, and diagnostic colonoscopies. Primary outcome includes evaluation of bubbles during colonoscopy graded using the Intraluminal Bubbles Scale. Secondary outcomes include evaluation of the Boston Bowel Preparation Scale (BBPS), total number of polyps, polyp size differentiation, polyp laterality, adenoma detection, mass detection, cecal insertion time, withdrawal time, and patient-reported adverse events. RESULTS Higher Intraluminal Bubbles grades III and IV (less than 75% of the mucosa cleared of bubbles/foam requiring intervention with simethicone infused wash) were detected in the placebo group [Simethicone n = 4/84 vs Placebo n = 20/84 (P = 0.007)]. BBPS total score was 7.42 [standard deviation (SD)=± 1.51] in the simethicone group and 7.28 (SD =± 1.44) in the placebo group (P = 0.542) from a total of 9. Significantly higher number of adenomas were detected in the simethicone group (P = 0.001). CONCLUSION The addition of simethicone to bowel preparation is well advised for its antifoaming properties. The results of this study suggest that addition of oral simethicone can improve bowel wall visibility. | Mohit Rishi Jaskarin Kaur Mark Ulanja Nicholas Manasewitsch Molly Svendsen Abubaker Abdalla Shashank Vemala Julie Kewanyama Karmjit Singh Nirmal Singh Nageshwara Gullapalli Eric Osgard | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，6： | 1 |
| 2 | SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit显示文摘BACKGROUND Timely and accurate identification of subgroup at risk for major adverse cardiovascular events among patients presenting with acute chest pain remains a challenge.Currently available risk stratification scores are suboptimal.Recently,a new scoring system called the Symptoms,history of Vascular disease,Electrocardiography,Age,and Troponin(SVEAT)score has been shown to outperform the History,Electrocardiography,Age,Risk factors and Troponin(HEART)score,one of the most used risk scores in the United States.AIM To assess the potential usefulness of the SVEAT score as a risk stratification tool by comparing its performance to HEART score in chest pain patients with low suspicion for acute coronary syndrome and admitted for overnight observation.METHODS We retrospectively reviewed medical records of 330 consecutive patients admitted to our clinical decision unit for acute chest pain between January 1st to April 17th,2019.To avoid potential biases,investigators assigned to calculate the SVEAT,and HEART scores were blinded to the results of 30-d combined endpoint of death,acute myocardial infarction or confirmed coronary artery disease requiring revascularization or medical therapy[30-d major adverse cardiovascular event(MACE)].An area under receiving-operator characteristic curve(AUC)for each score was then calculated.C-statistic and logistic model were used to compare RESULTS A 30-d MACE was observed in 11 patients(3.33%of the subjects).The AUC of SVEAT score(0.8876,95%CI:0.82-0.96)was significantly higher than the AUC of HEART score(0.7962,95%CI:0.71-0.88),P=0.03.Using logistic model,SVEAT score with cut-off of 4 or less significantly predicts 30-d MACE(odd ratio 1.52,95%CI:1.19-1.95,P=0.001)but not the HEART score(odd ratio 1.29,95%CI:0.78-2.14,P=0.32).CONCLUSION The SVEAT score is superior to the HEART score as a risk stratification tool for acute chest pain in low to intermediate risk patients. | Daniel Antwi-Amoabeng Chanwit Roongsritong Moutaz Taha Bryce David Beutler Munadel Awad Ahmed Hanfy Jasmine Ghuman Nicholas T Manasewitsch Sahajpreet Singh Claire Quang Nageshwara Gullapalli | 2022 | World Journal of Cardiology2022，14，8： | 0 |
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