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您的检索式：作者名="David Cangemi"
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| 1 | Changes in efficiency and resource utilization after increasing experience with double balloon enteroscopy显示文摘AIM:To investigate changes in efficiency and resource utilization as a single endoscopist's experience increased with each subsequent 100 double balloon enteroscopy(DBE) procedures.METHODS:We reviewed consecutive DBE procedures performed by a single endoscopist at our center over 4 years.DBE was employed when the clinician deemed the procedure was needed for disease management.The approach(oral,anal or both) was chosen based on suspected location of the target lesion.All DBE was performed in a standard endoscopy room with a portable fluoroscopy unit.Fluoroscopy was used to aid in shortening the small intestine and reducing bowel loops.For oral DBE,measurements were taken from the incisors.For anal DBE,measurements were taken from the anal verge.Enteroscopy continued until the target lesion was reached,until the entire small intestine was examined,or until no further progress was deemed possible.The length of small intestine examined(cm),procedure duration(min),and fluoroscopy time(s) were analyzed for sequential groups of 100 DBE.Sub-groups of diagnostic and therapeutic procedures were analyzed using multivariable linear regression.RESULTS:802 consecutive DBE procedures were analyzed.For oral DBE,median [interquartile range(IQR)] length of small bowel examined was 230.8 cm(range:210-248 cm) and for anal DBE was 143.5 cm(range:100-180 cm).No significant increase in length examined was noted for either the oral or anal approach with advancing position in series.In terms of duration of procedure,the median(IQR) for oral DBE was 86 min(range:71-105 min) and for anal DBE was 81.3 min(range:67-105 min).When comparing by the position in series,there was a significant(P value < 0.001) decrease in procedure duration for both upper and lower procedures with increasing experience.Median(IQR) time of exposure to fluoroscopy for oral DBE was 190 s(114-275) compared to anal DBE which was 196.4 s(312-128).This represented a significant(P value < 0.001) decrease in the amount of fluoroscopy used with increasing position in series.For both oral and anal DBE,fluoroscopy time was reduced by greater than 50% over the course of 802 total procedures performed.Sub-group analysis was conducted on therapeutic and diagnostic groups.Out of 802 procedures,a total of 434 were considered therapeutic.Argon plasma coagulation was by far the most common therapeutic intervention performed.There was no evidence of a difference in length examined or fluoroscopy exposure among oral DBE for diagnostic and therapeutic procedures,P = 0.91 and P = 0.32 respectively.The median(IQR) for length was 235 cm(range:178-280 cm) for diagnostic vs 230 cm(range:180-275 cm) for therapeutic procedures;additionally,fluoroscopy time median(IQR) was 180 s(range:110-295 s) and 162 s(range:102-263 s) for no intervention and intervention.However,there was a significant difference in procedure duration among oral DBE(P < 0.001).The median(IQR) was 80 min(range:60-97 min) and 94 min(range:77-110 min) for diagnostic and therapeutic interventions respectively.CONCLUSION:For a single endoscopist,increased DBE experience with number of performed procedures is associated with increased efficiency and decreased resource utilization. | Neal C Patel William C Palmer Kanwar R Gill David Cangemi Nancy Diehl Mark E Stark | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，3： | 2 |
| 2 | Randomized controlled trial of recombinant alpha-2a-interferon for chronic hepatitis C显示文摘 | David D. Douglas MD Dr. Jorge Rakela MD Hsiang Ju Lin DSc F. Blaine Hollinger MD Howard F. Taswell MD Albert J. Czaja MD John B. Gross MD Monte L. Anderson MD Kevin Parent MD C. Richard Fleming MD John R. Cangemi MD Peter C. O’Brien PhD Pauline E. Powis R | 1993 | Digestive Diseases and Sciences1993，，4： | 1 |
| 3 | Small Bowel Tumors Discovered During Double-Balloon Enteroscopy: Analysis of a Large Prospectively Collected Single-Center Database显示文摘 | David J. Cangemi Mihir K. Patel Victoria Gomez John R. Cangemi Mark E. Stark Frank J. Lukens | 2013 | Journal of Clinical Gastroenterology2013，，9： | 1 |
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