AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation...AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to SC.Relative risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59 cm and 0.56 cm,respectively(P = NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients(ClinicalTrials.gov Identifier:NCT01044732).展开更多
The new year has just begun and some of us are working hard to stick to our New Year's resolutions.Some are already struggling to stay or get back on the horse while the rest have just given up all together.Whatev...The new year has just begun and some of us are working hard to stick to our New Year's resolutions.Some are already struggling to stay or get back on the horse while the rest have just given up all together.Whatever stage you're at,something that you might not have thought about when planning your resolutions is your ticker.It's time we spoke about cardiovascular disease.展开更多
The new year has just begun and some of us are working hard to stick to our New Year's resolutions.Some are already struggling to stay or get back on the horse while the rest have just given up all together.Whatev...The new year has just begun and some of us are working hard to stick to our New Year's resolutions.Some are already struggling to stay or get back on the horse while the rest have just given up all together.Whatever stage you're at,something that you might not have thought about when planning your resolutions Is your ticker.It's time we spoke about cardiovascular disease.展开更多
Jonas Emil Carlson left his home in Sweden at 14 years old because of the country's potato shortage・Potatoes were a staple of the Swedish diet,and the blight caused widespread famine・With little more than the clot...Jonas Emil Carlson left his home in Sweden at 14 years old because of the country's potato shortage・Potatoes were a staple of the Swedish diet,and the blight caused widespread famine・With little more than the clothes on his back,Carls on decided to seek a better life in the United States・The new world imposed many changes on the young man,but one thing that did not change was his love of good coffee・That love of coffee has been passed down for two gen erations・Jonas Emil Cars on's grands on,and founder of Jo nas Emil Coffee Roasters,David Henry,tells That's about his business and also gave us some great coffee making tips.展开更多
Jonas Emil Carlson left his home in Sweden at 14 years old because of the country's potato shortage,Potatoes were a staple of the Swedish diet,and the blight caused widespread famine.With lttle more than the cloth...Jonas Emil Carlson left his home in Sweden at 14 years old because of the country's potato shortage,Potatoes were a staple of the Swedish diet,and the blight caused widespread famine.With lttle more than the clothes on his back,Carlson decided to seek a better life in the United States.展开更多
As we approach the long summer months and our kids get ready to take a long and well-deserved break from school,we invited the General Manager of Sofitel Sanya Leeman Resort,Mr.Marc de Beer to explain to us why adopti...As we approach the long summer months and our kids get ready to take a long and well-deserved break from school,we invited the General Manager of Sofitel Sanya Leeman Resort,Mr.Marc de Beer to explain to us why adopting a French style of living on the island is a great way to spend the holiday.展开更多
As we approach the long summer A months and our kids get ready Ato take a long and well-deserved break from school,we invited the General Manager of Sofitel Sanya Leeman Resort,Mr.Marc de Beer to explain to us why ado...As we approach the long summer A months and our kids get ready Ato take a long and well-deserved break from school,we invited the General Manager of Sofitel Sanya Leeman Resort,Mr.Marc de Beer to explain to us why adopting a French style of living on the island is a great way to spend the holiday.展开更多
基金Supported by A grant from Avantis Medical Systems,in part
文摘AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to SC.Relative risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59 cm and 0.56 cm,respectively(P = NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients(ClinicalTrials.gov Identifier:NCT01044732).
文摘The new year has just begun and some of us are working hard to stick to our New Year's resolutions.Some are already struggling to stay or get back on the horse while the rest have just given up all together.Whatever stage you're at,something that you might not have thought about when planning your resolutions is your ticker.It's time we spoke about cardiovascular disease.
文摘The new year has just begun and some of us are working hard to stick to our New Year's resolutions.Some are already struggling to stay or get back on the horse while the rest have just given up all together.Whatever stage you're at,something that you might not have thought about when planning your resolutions Is your ticker.It's time we spoke about cardiovascular disease.
文摘Jonas Emil Carlson left his home in Sweden at 14 years old because of the country's potato shortage・Potatoes were a staple of the Swedish diet,and the blight caused widespread famine・With little more than the clothes on his back,Carls on decided to seek a better life in the United States・The new world imposed many changes on the young man,but one thing that did not change was his love of good coffee・That love of coffee has been passed down for two gen erations・Jonas Emil Cars on's grands on,and founder of Jo nas Emil Coffee Roasters,David Henry,tells That's about his business and also gave us some great coffee making tips.
文摘Jonas Emil Carlson left his home in Sweden at 14 years old because of the country's potato shortage,Potatoes were a staple of the Swedish diet,and the blight caused widespread famine.With lttle more than the clothes on his back,Carlson decided to seek a better life in the United States.
文摘As we approach the long summer months and our kids get ready to take a long and well-deserved break from school,we invited the General Manager of Sofitel Sanya Leeman Resort,Mr.Marc de Beer to explain to us why adopting a French style of living on the island is a great way to spend the holiday.
文摘As we approach the long summer A months and our kids get ready Ato take a long and well-deserved break from school,we invited the General Manager of Sofitel Sanya Leeman Resort,Mr.Marc de Beer to explain to us why adopting a French style of living on the island is a great way to spend the holiday.
