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Gastrointestinal Procedures (gastrointestinal + procedure)

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Medical Sciences100%

Selected Abstracts

Diagnosis and treatment of gastroesophageal reflux disease in Ohio Medicaid patients: practice patterns and temporal trends,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2004
Gregory S. Cooper MD
Abstract Purpose There is a paucity of data about the use of procedures and prescription medications in the treatment of gastroesophageal reflux disease (GERD) in actual clinical practice. Methods Outpatient Ohio Medicaid claims from 1994 to 1998 were searched to identify patients with an initial diagnosis of GERD along with associated prescriptions and gastrointestinal procedures. Complications of GERD and comorbid illnesses were also determined. Results A total of 5579 patients were identified. Histamine-2 receptor antagonists (H2RA') were prescribed in 59%, followed by proton pump inhibitors (PPI's) (30%) and prokinetic drugs (17%). PPI's were more frequently prescribed to patients with GERD-related complications, peptic ulcer disease and major comorbidities, and patients who received PPI's were also more likely to undergo upper gastrointestinal endoscopy. The frequencies of upper endoscopy and barium studies were 20% and 11% respectively, with no change over the study period. There was an increased frequency of PPI therapy (17,43%) and decreased frequency of H2RA therapy (72,47%) from 1994 to 1998 which persisted after adjusting for potential differences in case mix. Conclusions In this population-based study, prescription of PPI's increased over time which likely reflected changes in clinician practice rather than patient mix. Despite a greater awareness of GERD complications, use of upper endoscopy did not increase. Although the cohort consists of predominantly low socioeconomic status, female patients, further studies should be conducted in other populations to confirm these findings. Copyright © 2003 John Wiley & Sons, Ltd. [source]

Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programme

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2010
J Williams
No abstract is available for this article. [source]

Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programme

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2010
R Naik
No abstract is available for this article. [source]

Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programme

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2010
R Naik
Objective, An analysis of surgical experience in gastrointestinal procedures within a UK-based gynaecological oncology centre to which subspecialty fellows within the subject are exposed. Design, Retrospective study. Setting, Northern Gynaecological Oncology Centre, Gateshead, UK. Population, All women undergoing bowel surgery over a six-year period, 1 January 2000 to 31 December 2005. Methods, Cases were analysed by specialty and grade of surgeon performing the procedure. Main outcome measure, Proportion of cases to which subspecialty fellows were exposed. Results, Two hundred and sixty-two women (11.5%) underwent bowel surgery out of 2280 women undergoing major surgery for gynaecological cancer. This included ovarian/primary peritoneal cancer in 186 women (71%). Of these 262 cases, 238 operations (91%) were performed by a gynaecological oncologist, 20 (7.5%) were performed jointly with the gastrointestinal surgeons and four (1.5%) were performed solely by the gastrointestinal surgeons. A gynaecological oncology subspecialty fellow performed 21 (8%) and assisted in an additional 204 operations (78%). Perioperative morbidity and mortality statistics in addition to overall survival outcomes were comparable to the published literature. Conclusions, A significant proportion of major surgical operations performed within a gynaecological oncology centre require gastrointestinal procedures. The majority of these procedures can be performed by gynaecological oncologists with an acceptable perioperative morbidity and mortality rate. Subspecialty training has the potential to allow trainees significant exposure to these procedures. An accredited post-Fellowship Training Programme can provide the opportunity for hands-on experience to allow gynaecological oncologists the confidence and credibility to perform these procedures independently. [source]