Browsing by Author "Croffie, Joseph M."

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    Pediatric bowel preparation: Sodium picosulfate, magnesium oxide, citric acid vs polyethylene glycol, a randomized trial
    (Baishideng Publishing Group Inc, 2020-10) Cuffari, Carmen; Ciciora, Steven L; Ando, Masakazu; Boules, Mena; Croffie, Joseph M.; Pediatrics, School of Medicine
    Bowel preparation in children can be challenging. AIM To describe the efficacy, safety, and tolerability of sodium picosulfate, magnesium oxide, and citric acid (SPMC) bowel preparation in children. METHODS Phase 3, randomized, assessor-blinded, multicenter study of low-volume, divided dose SPMC enrolled children 9-16 years undergoing elective colonoscopy. Participants 9-12 years were randomized 1:1:1 to SPMC ½ dose × 2, SPMC 1 dose × 2, or polyethylene glycol (PEG). Participants 13-16 years were randomized 1:1 to SPMC 1 dose × 2 or PEG. PEG-based bowel preparations were administered per local protocol. Primary efficacy endpoint for quality of bowel preparation was responders (rating of ‘excellent’ or ‘good’) by modified Aronchick Scale. Secondary efficacy endpoint was participant’s tolerability and satisfaction from a 7-item questionnaire. Safety assessments included adverse events (AEs) and laboratory evaluations. RESULTS 78 participants were randomized, 48 were 9-12 years, 30 were 13-16 years. For the primary efficacy endpoint in 9-12 years, 50.0%, 87.5%, and 81.3% were responders for SPMC ½ dose × 2, SPMC 1 dose × 2, and PEG groups, respectively. Responder rates for 13-16 years were 81.3% for SPMC 1 dose × 2 and 85.7% for PEG. Overall, 43.8% of participants receiving SPMC 1 dose × 2 reported it was ‘very easy’ or ‘easy’ to drink, compared with 20.0% receiving PEG. Treatment-emergent AEs were reported by 45.5% of participants receiving SPMC 1 dose × 2 and 63.0% receiving PEG. CONCLUSION SPMC was an efficacious and safe for bowel preparation in children 9-16 years, with comparable efficacy to PEG. Tolerability for SPMC was higher compared to PEG.
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    Retrograde gastroesophageal intussusception: Initial presenting feature of achalasia in a teenager
    (Elsevier, 2019-11) Morocho, Bryant; Bose, Paroma; Grayson, Britney; Croffie, Joseph M.; Billmire, Deborah F.; Surgery, School of Medicine
    A 16-year-old Caucasian male presented with acute vomiting and dysphagia. Imaging studies revealed retrograde gastroesophageal intussusception (RGEI), which reduced prior to diagnostic laparoscopy. No clear etiology for RGEI was identified at that time, so further surgical intervention was deferred. He returned several months later with persistent dysphagia. Imaging, endoscopy, and endoluminal function imaging probe then diagnosed achalasia. He underwent a second laparoscopy for Heller myotomy and Dor fundoplication. This is the first report of RGEI preceding a diagnosis of achalasia.