Browsing by Author "Hilsden, Robert J"

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    Capsule endoscopy versus standard of care in obscure gastrointestinal bleeding: A randomized controlled trial
    (2017) Adams, Fatin; Hilsden, Robert J; Dube, Jeanne Catherine; Kaplan, Gil; McGregor, Elizabeth SE
    Iron deficiency anemia (IDA) is a common problem worldwide. The initial workup usually involves performing a bidirectional endoscopy. When negative, the small bowel could be the source of obscure gastrointestinal bleeding presenting as IDA. The next best diagnostic test is uncertain. Wireless capsule endoscopy (WCE) is a non-invasive new technology that allows examination of the entire small bowel. Methods: We designed a randomized controlled pilot study to outline the challenges for conducting a full randomized controlled trial (RCT) to determine if WCE should be first-line investigation in such cases. 109 patients were enrolled; 55 intervention (WCE) & 54 controls (standard of care) (SC). Results: Two-years post-randomization there was no difference in anemia between the two groups. Conclusion: Few methodological hurdles for conducting a full RCT were identified.
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    Effects of physical activity on colorectal cancer risk among family history and body mass index subgroups: a systematic review and meta-analysis
    (2018-01-11) Shaw, Eileen; Farris, Megan S; Stone, Chelsea R; Derksen, Jeroen W G; Johnson, Rhys; Hilsden, Robert J; Friedenreich, Christine M; Brenner, Darren R
    Abstract Background Physical activity is consistently associated with a reduced risk of colorectal cancer in epidemiologic studies. This association among higher risk subgroups, such as those with a first-degree family history of colorectal cancer or high body mass index remains unclear. Methods We searched MEDLINE for studies examining physical activity and colorectal cancer risk among higher risk subgroups through July 11, 2017. Fifteen and three studies were eligible for inclusion for body mass index and first-degree family history of colorectal cancer subgroups, respectively. Estimates of the highest to lowest comparison of physical activity for each subgroup of risk were pooled using random-effects models. Results The pooled associations of physical activity and colorectal cancer risk for those without and with a first-degree family history of colorectal cancer were 0.56 (95% confidence interval (CI) = 0.39–0.80) and 0.72 (95% CI = 0.39–1.32), respectively (pheterogeneity = 0.586). The pooled associations of physical activity and colorectal cancer risk for the low and high body mass index groups were 0.74 (95% CI = 0.66–0.83) and 0.65 (95% CI = 0.53–0.79), respectively (pheterogeneity = 0.389). Conclusions Overall, a stronger relative risk of physical activity on colorectal cancer risk was observed in the higher body mass index group, although the difference was not statistically significant, suggesting an added benefit of physical activity as a cancer prevention strategy in population groups with strong risk factors for colorectal cancer. Additional research among these subgroups is warranted.