Gastrointestinal Endoscopy Clinics of North America (Gastrointest Endosc Clin )

Publisher: Elsevier


Each issue of Gastrointestinal Endoscopy Clinics reviews new diagnostic and management techniques for a single clinical problem--and makes them simple to apply. Its concise, comprehensive, and its editors and authors are respected experts.

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  • 5-year impact
  • Cited half-life
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  • Article influence
  • Website
    Gastrointestinal Endoscopy Clinics website
  • Other titles
    Gastrointestinal endoscopy clinics of North America
  • ISSN
  • OCLC
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
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    • Voluntary deposit by author of pre-print allowed on Institutions open scholarly website and pre-print servers
    • Voluntary deposit by author of authors post-print allowed on institutions open scholarly website including Institutional Repository
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    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PMC after 12 months
    • Authors who are required to deposit in subject repositories may also use Sponsorship Option
    • Pre-print can not be deposited for The Lancet
  • Classification
    ‚Äč green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Endoscopic sedation has traditionally been considered to be an element of the endoscopic examination. Endoscopists, together with endoscopy nurses, administered benzodiazepines and opioids with acceptable safety and efficiency. Today, sedation practices for endoscopy have become more diversified due to the entry of anesthesia specialists into the endoscopy unit, gastroenterologist-directed propofol administration, and prolonged diagnostic and therapeutic procedures that require deeper sedation. The economic implications of these changes in sedation are examined in this article.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):665-78, viii.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Endoscopic sedation is changing, in response to economic pressures, regulatory requirements, and new technology. Each endoscopy unit must tailor its personnel and equipment practices to its particular case mix, sedation preferences, and to its external environment. This article discusses sedation-related considerations regarding procedure room design, equipment for drug administration, equipment for patient monitoring, equipment for managing emergencies, and staff selection, training, and responsibilities.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):641-9, vii.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Gastroenterologist directed propofol has been proven safe in more than 220,000 published cases. Administration of low doses of opioid and/or benzodiazepine ("balanced propofol sedation") is the safest format for gastroenterologist directed propofol. Specific training is needed to undertake gastroenterologist directed propofol administration.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):717-25, ix.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A thorough and efficient pre-procedure evaluation of the patient's readiness to undergo sedation for endoscopy is essential. This evaluation will allow the formulation of an appropriate sedation plan for the patient, resulting in a safe and effective examination. The post procedure assessment of the patient confirms readiness for discharge and allows for appropriate patient education and follow-up planning.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):627-40, vii.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The availability of endoscopy as a diagnostic and therapeutic tool has caused the number of procedures performed in the United States to greatly increase; additionally, the volume and complexity of endoscopic procedures performed under sedation, including difficult procedures performed on frail and severely ill patients, has increased. The goals of endoscopic sedation are to provide patients with a successful procedure and to ensure that they remain safe and are relieved from anxiety and discomfort; agents should provide efficient, appropriate sedation and allow patients to recover rapidly. Sedation is usually both safe and effective; however, complications may ensue. This article will explore medicolegal aspects of sedation, such as the importance of informed consent for sedation, the difficulties of assessing withdrawal of consent in a sedated patient, and the need for sedation monitoring which meets accepted standard of care. Controversies involving GI directed propofol and the use of anesthesia personnel to deliver sedation for endoscopy are also discussed.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):783-8, x.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The role of sedation in endoscopic procedures has increased and so has the demand for advances in its administration. The pursuit of new agents or administration techniques and their study specific to endoscopic nonsurgical procedures is necessary to improve patient comfort and safety.The science of moderate and deep sedation specific to endoscopy is fledgling but approaching new horizons.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):789-99, x.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Over the past several years office-based procedures with sedation have become increasingly more common. It must be appreciated that not all procedures are well suited for this type of environment. Unacceptable ones would include those associated with significant fluid shifts, post-operative pain, bleeding or procedures of long duration. Since esophagogastroduodenoscopy (EGD) and colonoscopy are relatively non-invasive, of short duration, and not associated with either fluid shifts or significant post-procedure discomfort. In appropriate patients, these procedures are well-suited to office-based practice.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):707-16, viii.
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    ABSTRACT: Patient monitoring is intended to reduce the risk of sedation-related cardiopulmonary complications. Physiological monitoring and visual assessment by a qualified individual should be routine during endoscopic procedures. Additionally, ventilatory monitoring should be considered for high-risk patients and those receiving sedation with propofol.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):651-63, vii.
  • Source
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    ABSTRACT: Patient simulation is now considered to be a valid method for the education and evaluation of providers of sedation. Using full-scale human simulators to provide a realistic setting, participants can acquire skills for patient monitoring, administration of sedation medications, and the recognition and management of critical events. Although obstacles to its implementation exist, it appears likely that simulation training will become an integral part of training for providers of procedural sedation.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):801-13, x.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A robust performance improvement program based in a community gastrointestinal (GI) practice is described. The need for continual improvement and attention to both quality and the bottom line is now essential for independent GI practices. This article provides both a roadmap for developing a program and benchmarks derived from a large integrated single specialty GI practice.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):753-71, ix.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Properly trained nursing personnel and allied staff are essential to the safe and effective practice of endoscopic sedation. Such individuals should possess a thorough understanding of the pharmacology of sedation agents, as well as the ability to monitor patients under sedation, recognize potential complications, and initiate appropriate and timely interventions. The endoscopy nurse or assistant must also understand their institutional policies and procedures pertaining to procedural sedation.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):695-705, viii.
  • [Show abstract] [Hide abstract]
    ABSTRACT: More than 20 million endoscopic procedures are performed in the United States annually. More than 98% of these endoscopies are performed with sedation. This includes both diagnostic and therapeutic procedures. Sedation reduces a patient's anxiety and discomfort, often improving their satisfaction with the procedure. Sedation creates a relaxed patient and a relaxed procedure environment allowing for a successful endoscopic examination.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):679-93, viii.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The 21(st) century has witnessed burgeoning interest in airway management. Pertinent basic sciences are covered in numerous texts and lectures. This article presents clinical information required to perform airway management. It serves as a primer for those interested in learning airway management skills. It does not replace extensive practice under the tutelage of expert airway managers.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):773-82, ix.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Best sedation practices for pediatric endoscopy involve the consideration of many patient factors, including age, medical history, clinical status, and anxiety level, as well as physician access to anesthesia support. A recent survey of pediatric gastroenterologists suggests that endoscopist-administered intravenous (iv) sedation and anesthesiologist-administered propofol represent common sedation regimens in children. Technical advances in ventilatory monitoring are contributing to increased patient safety for all children undergoing gastrointestinal procedures, regardless of sedation type.
    Gastrointestinal Endoscopy Clinics of North America 11/2008; 18(4):739-51, ix.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pancreatic cancer is the fifth leading cause of cancer-related deaths in Japan. Small pancreatic cancers have some abnormal findings on ultrasonography, and diagnosis with endosonography is useful. Positron emission tomography and contrast-enhanced ultrasonography are expected to serve as new modalities for the early detection of pancreatic cancer. The identification of high-risk individuals is necessary to perform efficient screening. Intraductal papillary mucinous neoplasms and chronic pancreatitis are important risk factors for pancreatic cancer.
    Gastrointestinal Endoscopy Clinics of North America 08/2008; 18(3):555-64, x.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Confocal laser endomicroscopy enables in vivo microscopy of the mucosal layer of the gastrointestinal tract with subcellular resolution during ongoing endoscopy. Endomicroscopy opens the door to immediate tissue and vessel analysis. Different types of diseases can be diagnosed with optical surface and subsurface analysis. Analysis of the in vivo microarchitecture can be used for targeting biopsies to relevant areas, and subsurface imaging can unmask microscopic diseases or bacterial infection. Molecular imaging is becoming feasible, which will enable new indications in gastrointestinal endoscopy. This article reviews the current and rapidly expanding clinical data on endomicroscopy and gives a look into future research.
    Gastrointestinal Endoscopy Clinics of North America 08/2008; 18(3):451-66, viii.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Early gastric cancer is a curable disease regardless of its location, histologic type, genetic changes, or the ethnicity of the patient. To improve the detection rate of early gastric cancer, intensive training of endoscopists and the use of novel endoscopic techniques have been introduced into routine examinations in Japan. In the United States, where most gastric cancer is found in advanced stages, a similar approach should be advocated. Endoscopic resection of high-grade dysplasia is also encouraged in the United States not only for proper diagnosis but also for achieving cure without surgical intervention.
    Gastrointestinal Endoscopy Clinics of North America 08/2008; 18(3):513-22, ix.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Colon cancer screening can be effective, but only with a high-quality program that assures adherence to all elements of the program. There is evidence in the United States of greater acceptance of screening and decreased incidence and mortality of colorectal cancer. Patient education is a key element of any effective screening program. It is hoped that future screening will develop better risk-stratification tools and enable targeting of screening to high-risk individuals.
    Gastrointestinal Endoscopy Clinics of North America 08/2008; 18(3):595-605, xi.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Esophageal adenocarcinoma is the most common type of esophageal cancer seen in the United States and Western Europe. Barrett's esophagus (BE) is a well-known risk factor for esophageal adenocarcinoma and is believed to be found in 6% to 12% of patients undergoing endoscopy for gastroesophageal reflux disease and in more than 1% of all patients undergoing endoscopy. This article focuses on the pathogenesis, treatment, and prevention of BE.
    Gastrointestinal Endoscopy Clinics of North America 08/2008; 18(3):495-512, ix.

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