McLean McNamara (bobcatwrench76)

ernal-fetal complications. We discuss the latest options in antiviral therapy and vaccine development, including the novel use of chloroquine in the management of COVID-19. Fetal surveillance, in view of the predisposition to growth restriction and special considerations during labor and delivery are addressed. Additionally, we focus on keeping frontline obstetric care providers safe while continuing to provide essential services. Our clinical service model is built around the principles of workplace segregation, responsible social distancing, containment of cross-infection to healthcare providers, judicious use of personal protective equipment and telemedicine. Our aim is to share a framework which can be adopted by tertiary maternity units managing pregnant women in the flux of a pandemic while maintaining the safety of the patient and healthcare provider at its core. BACKGROUND AND AIMS A prior randomized study (Surveillance versus Radiofrequency Ablation study [SURF study]) demonstrated that radiofrequency ablation (RFA) of Barrett's esophagus (BE) with confirmed low-grade dysplasia (LGD) significantly reduces the risk of esophageal adenocarcinoma. Our aim was to report the long-term outcomes of this study. METHODS The SURF study randomized BE patients with confirmed LGD to RFA or surveillance. For this retrospective cohort study, all endoscopic and histological data acquired after end of the SURF study in May 2013 until December 2017 were collected. The main outcome was rate of progression to HGD/cancer. All 136 patients randomized to RFA (n=68) or surveillance (n=68) in the SURF study were included. After closure of the SURF study, 15 surveillance patients underwent RFA based on the patient's preference and the outcomes of the study RESULTS With 40 (IQR 12-51) additional months, the total median follow-up from randomization to last endoscopy was 73 (IQR 46-85) months. HGD/cancer was diagnosed in 1 patient in the RFA group (1.5%) and 23 in the surveillance group (33.8%) (p 0.000), resulting in an absolute risk reduction of 32.4% (95% CI, 22.4%-44.2%) with a number needed to treat of 3.1 (95% CI, 2.3-4.5). Seventy-five out of 83 patients (90%; 95% CI, 82.1%-95.0%) treated with RFA for BE reached complete clearance of BE and dysplasia. BE recurred in 7 out of 75 patients (9%; 95% CI, 4.6%-18.0%) mostly minute islands or tongues, LGD in 3 out of 75 (4%; 95% CI, 1.4%-11.1%). CONCLUSIONS RFA of BE with confirmed LGD significantly reduces risk of malignant progression, with sustained clearance of BE in 91% and LGD in 96% of patients, after a median follow-up of 73 months. BACKGROUND AND AIMS A significant portion of patients regain weight after Roux-en-Y gastric bypass (RYGB). Both ablation with argon plasma coagulation (APC) plus endoscopic full-thickness suturing (FTS-APC) and ablation alone have been reported at treating weight regain when associated with gastrojejunostomy (GJ) dilation. However, comparative controlled data are still lacking. METHODS This was a pilot single-center open-label randomized trial comparing the effectiveness and safety of APC alone versus FTS-APC in performing transoral outlet reduction. Patients with at least 20% weight regain from the nadir, and GJ ≥15 mm were considered eligible. The primary outcome was % total weight loss (%TWL) at 12 months. Secondary outcomes were the incidence of adverse events, amelioration of metabolic laboratory parameters, and improvement in quality of life (QOL) and eating behavior. RESULTS Forty patients meeting eligibility criteria were enrolled from October 2017 to July 2018. Technical and clinical success rates were similar between groups. At 12 months, the mean %TWL was 8.3 ± 5.5 in the APC alone group versus 7.5 ± 7.7% in the FTS-APC group (p=0.71). The prerevisional % solid gastric retention at 1 hour positively correlated with the probability of achieving ≥10% TWL at 12 months. Both groups experienced significant reductions in LDL and triglycerides levels at