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- 저자 : Saurabh Chawla (검색결과 2 건)
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Epidemiology of early esophageal adenocarcinoma
Thuy-Van P. Hang,Zachary Spiritos,Anthony M. Gamboa,Zhengjia Chen,Seth Force,Vaishali Patel,Saurabh Chawla,Steven Keilin,Nabil F. Saba,Bassel El-Rayes,Qiang Cai,Field F. Willingham 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3
Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma(EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates amongmajor epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according totumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data wereavailable. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annualpercent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%−5.56%). The annual percent change appearedto plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of −5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelialmalignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients hasnode negative, potentially resectable early stage disease.
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Parit Mekaroonkamol,Kasenee Tiankanon,Rapat Pittayanon,Wiriyaporn Ridtitid,Fariha Shams,Ghias Un Nabi Tayyab,Julia Massaad,Saurabh Chawla,Stanley Khoo,Siriboon Attasaranya,Nonthalee Pausawasdi,Qiang C 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2
Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopyduring the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of therecommendations and the perceptions of endoscopy personnel on them. Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%)from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scopecleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between thevariables. Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), theirpracticality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, andp=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), lessworking experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalentcountries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations lesspractical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19patients was associated with less agreement with PPE recommendations (p=0.039). Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resourceavailability and local prevalence are critical factors influencing the adoption of the current guidelines.
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