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RISS 인기검색어
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- 저자 : Alyssa Choi (검색결과 3 건)
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Trust in Medicine throughout Health Policy Change in the United States
( Alyssa Peachey ),( Sung W. Choi ) 한국정책학회 2019 International Journal of Policy Studies Vol.10 No.1
Despite the increasing number of in healthcare, the public is less confident in medicine today than 30 years ago. Decreased trust in medicine is problematic because fewer people will go to their doctor or comply with their medical treatments. The purpose of this research is to analyze the impact of healthcare policy change on the public’s confidence in Medicine, compared to several other large institutions including education, finance and all other institutions. Using 2006 - 2016 General Social Survey data, an ordered logistic regression model was adopted to analyze the association of the Affordable Care Act implementation with public trust in medicine over other institutions, controlling for respondents’ socioeconomic characteristics, demographic backgrounds and self-rated health. The odds of trusting medicine over other large institutions increased by 17.92% after implementation of the ACA. The multiple reasons behind increased public trust in medicine over other institutions were discussed.
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Diagnosis and Management of Gastric Intestinal Metaplasia: Current Status and Future Directions
Robert J. Huang,Alyssa Y. Choi,Camtu D. Truong,Matthew M. Yeh,Joo Ha Hwang 거트앤리버 소화기연관학회협의회 2019 Gut and Liver Vol.13 No.6
Gastric intestinal metaplasia (GIM) is a known premalignant condition of the human stomach along the pathway to gastric cancer (GC). Histologically, GIM represents the replacement of normal gastric mucosa by mucin-secreting intestinal mucosa. Helicobacter pylori infection is the most common etiologic agent of GIM development worldwide. The prevalence of GIM is heterogeneous among different regions of the world and correlates with the population endemicity of H. pylori carriage, among other environmental factors. GC remains the third leading cause of cancer-related mortality globally. GIM is usually diagnosed by upper endoscopy with biopsy, and histologic scoring systems have been developed to riskstratify patients at highest risk for progression to GC. Several recent endoscopic imaging modalities may improve the optical detection of GIM and early GC. Appropriate surveillance of GIM may be cost effective and represents an opportunity for the early diagnosis and therapy of GC. Certain East Asian nations have established population-level programs for the screening and surveillance of GIM; guidelines regarding GIM surveillance have also recently been published in Europe. By contrast, few data exist regarding the appropriateness of surveillance of GIM in the United States. In this review, we discuss the pathogenesis, epidemiology, diagnosis, and management of GIM with an emphasis on the role of appropriate endoscopic surveillance.
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Hybrid argon plasma coagulation in Barrett’s esophagus: a systematic review and meta-analysis
Sagar N. Shah,Nabil El Hage Chehade,Amirali Tavangar,Alyssa Choi,Marc Monachese,Kenneth J. Chang,Jason B. Samarasena 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.1
Background/Aims: Patients with Barrett’s esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapiesaim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injectionto create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis toevaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplasticand non-dysplastic Barrett’s esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures includedcomplete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessaryto achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872–0.939;I2=0%). Pooled stricture rate was 2.0% (95% CI, 0.005–0.042; I2=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007–0.055;I2=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safetyprofile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlledtrials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparableto the current standards of care.
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