scholarly journals Bowel preparation for performing a colonoscopy: prospective randomized comparison study between a low-volume solution of polyethylene glycol and bisacodyl versus bisacodyl and a mannitol solution

2012 ◽  
Vol 49 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Manoel Carlos Vieira ◽  
Claudio Lyoiti Hashimoto ◽  
Flair José Carrilho
Keyword(s):  
Polyethylene Glycol ◽  
Vital Signs ◽  
Abdominal Distension ◽  
Similar Efficacy ◽  
Preparation Methods ◽  
Gold Standard Method ◽  
Mannitol Solution ◽  
Before And After ◽  
Glycol Solution

CONTEXT: Colonoscopy is currently the gold standard method to examine the colon, the rectum and the terminal ileum. In order to perform the colonoscopy, it is necessary to clean the bowel and use medications that are generally poorly tolerated by the patients. OBJECTIVE: Compare the tolerability, acceptability, safety and efficacy of two solutions used for intestinal preparation for a colonoscopy. METHODS: One hundred patients matched for sex and age were prospective randomized into two groups. Polyethylene glycol group received bisacodyl 10 mg plus 1 L of polyethylene glycol the night before and 1 L on the day of the exam. Mannitol group received bisacodyl 20 mg the day before and 1 L of a 10% mannitol solution on the day of the exam. The diet was the same for both groups. Tolerability and acceptability were measured using previously validated questionnaires. In terms of safety, variations in vital signs before and after the preparation were recorded, in addition to any complications. The quality of the preparation was graded based on the Boston and Ottawa scales. RESULTS: Ninety-six percent (96%) completed the study. As for tolerability, the mannitol preparation group exhibited a significantly higher frequency of nausea, vomiting, abdominal pain, and abdominal distension than polyethylene glycol group (P < 0.05). Acceptability was significantly better in polyethylene glycol group. The polyethylene glycol solution has also previously been shown to be safer than mannitol. No difference was observed in the quality of the preparation between the two preparation methods. CONCLUSIONS: The following conclusions can be made: polyethylene glycol solution had higher tolerability, acceptability, and safety than the mannitol and should be used instead of mannitol. Both preparation solutions have similar efficacy.

scholarly journals Safety of Polyethylene Glycol Solution plus Ascorbic Acid for Bowel Preparation for Colonoscopy in Patients with Chronic Kidney Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Naoki Ohmiya ◽  
Yoshihito Nakagawa ◽  
Noriyuki Horiguchi ◽  
Takafumi Omori ◽  
Toshiaki Kamano ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ascorbic Acid ◽  
Polyethylene Glycol ◽  
Kidney Disease ◽  
Adverse Events ◽  
Bowel Preparation ◽  
Vital Signs ◽  
Before And After ◽  
Blood And Urine Samples ◽  
Glycol Solution

Introduction. Polyethylene glycol-electrolyte lavage solution plus ascorbic acid (PEG-ELS-Asc) has been recommended for colonoscopy, but little is known about the safety of PEG-ELS-Asc in patients with chronic kidney disease (CKD). The aim of this study was to determine its safety and efficacy in CKD patients. Methods. Blood and urine samples prospectively collected before and after same-day bowel preparation for colonoscopy with the conventional volume of PEG-ELS-Asc, vital signs before and after colonoscopy, and adverse events within 30 days postcolonoscopy were analyzed in consenting patients with CKD. The cleansing level was evaluated with the Boston bowel preparation score (BBPS) from colonoscopic findings. Results. Of 57 patients enrolled, 1 was excluded for refusal. Serum bicarbonate significantly dropped, and blood hemoglobin, serum total protein, albumin, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, total bilirubin, and uric acid significantly rose after bowel preparation, although these changes were not clinically important. Only in nondialysis patients did the platelet count and potassium significantly rise, although these changes were not clinically important either. Renal function, such as the urea, creatinine, and estimated glomerular filtration rate, was not significantly altered. An adequate bowel cleansing score, BBPS ≥ 6 , was achieved in 94% of patients. The blood pressure and heart rate were not significantly different between before and after colonoscopy in either nondialysis ( n = 32 ) or dialysis ( n = 19 ) patients. There were no adverse events associated with bowel preparation and colonoscopy within 30 days postcolonoscopy. Conclusions. The conventional volume of same-day bowel preparation with PEG-ELS-Asc may be safe and effective in CKD patients.

scholarly journals Physiological quality of osmoprimed Eremanthus erythropappus (D.C.) MacLeish seeds

2020 ◽  
Vol 13 (5) ◽  
pp. 18
Author(s):  
A. M. S. Oliveira ◽  
A. A. Silva ◽  
M. C. Vasconcelos ◽  
J. A. A. Granja ◽  
J. M. R. Faria ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Germination Rate ◽  
Seed Priming ◽  
Potassium Nitrate ◽  
The Other ◽  
Other Substances ◽  
Physiological Quality ◽  
Glycol Solution ◽  
Polyethylene Glycol 6000

Physiological conditioning is a technique that consists in controlling the speed of water uptake by seeds, with osmotic solutions, aiming to improve their quality, reducing time and increasing germination rate. Eremanthus erythropappus (D.C.) MacLeish seeds were subjected to priming with polyethylene glycol 6000 (PEG), potassium nitrate (KNO3) and the combination of the two at the concentrations of 0.4; -0.8; -1.0; -1.2 and -1.4 MPa for four, six and eight days. Germination, germination speed index (GSI), emergence, emergence speed index (ESI) and expression of superoxide dismutase (SOD), catalase (CAT) and peroxidase (PO) enzymes were assessed. E. erythropappus seed priming in polyethylene glycol solution with potentials between -0.8 MPa and -1.4 MPa is not satisfactory because it adversely affects germination and reduces the activity of peroxidase and catalase enzymes. The other substances were not significant so there is a need for further research with other substances and / or concentrations

scholarly journals Comparison of Polyethylene Glycol Powder and Polyethylene Glycol 40% Syrup in Treatment of Chronic Idiopathic Constipation in Pediatrics

2019 ◽  
pp. 1-8
Author(s):  
Karam-Ali Kasiri ◽  
Kiavash Fekri ◽  
Hojjat Rouhi-Boroujeni ◽  
Masoud Lotfizadeh ◽  
Nabiallah Asadpour ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Functional Constipation ◽  
Similar Efficacy ◽  
Ease Of Use ◽  
Idiopathic Constipation ◽  
Stool Incontinence ◽  
Before And After ◽  
Group 2 ◽  
Simple Sampling ◽  
High Level

Introduction: Constipation is one of the most common gastrointestinal complaints in children that can lead to many complications. The aim of this study was to compare the efficacy of polyethylene glycol powder and polyethylene glycol 40% syrup to treat constipation. Materials and Methods: This study was a nonrandomized semi-experimental clinical trial. The current study was conducted on 80 patients with constipation, referring to Imam Ali (PBUH) Clinic, Shahrekord randomly assigned to two groups of 40 each. Subjects were children under 15 years old with functional constipation selected by simple sampling since 2015. Group 1 was treated with polyethylene glycol powder and Group 2 was treated with polyethylene glycol 40% syrup for two months. During the treatment, the patients were examined five times with 2-week intervals and their symptoms consisting of defecation frequency, stool consistency, painful defecation, bloody defecation, and stool incontinence were registered in a checklist. Data were analyzed using SPSS24. Results: The comparison of patients’ total status before and after intervention shows that two groups were assessed in the weak level in the polyethylene glycol powder group 28(0.70%) cases and syrup group 36(0.90%), while after intervention, polyethylene glycol powder group was assessed in the high level 35(87.5%) cases and syrup group 37(92%) cases and most of patients after intervention promoted from weak and intermediate level before intervention to High level. Conclusion: The findings indicated similar efficacy and treatment response of the PEG powder and syrup. However, the PEG syrup can be used instead of its powder because of pleasant taste and ease of use.

scholarly journals 2L of Polyethylene Glycol as the Main Small Bowel Cleansing Regimen Component Prior to Video Capsule Endoscopy: Interim Analysis

2020 ◽  
Vol 74 (2) ◽  
pp. 83-87
Author(s):  
Aleksejs Derovs ◽  
Jeļena Derova ◽  
Regīna Kleina ◽  
Juris Pokrotnieks
Keyword(s):  
Polyethylene Glycol ◽  
Small Bowel ◽  
Transit Time ◽  
Capsule Endoscopy ◽  
Interim Analysis ◽  
Preparation Methods ◽  
Diagnostic Endoscopy ◽  
Factors Influencing ◽  
Bowel Cleansing

AbstractCapsule Enteroscopy (CE) is a fundamentally new method in diagnostic endoscopy. However, there are several factors influencing the quality of this procedure, including impermeable fluids, food remains etc. The aim of the study was to assess one of the most popular currently used bowel preparation methods and evaluate possible effects of various factors. 136 CE examinations were analysed. Each patient was prepared using 2 litres of polyethylene glycol (PEG) one day prior to examination. There was a special form filled in for each patient, which included relevant parameters (anamnesis, CE data etc.). Of 136 CE cases, 84 (61.8%) were female patients and 52 (38.2%) were male. The small bowel (SB) transit time in 112 patients varied from 39 to 502 minutes, but in 24 cases the capsule did not reach caecum. The degree of bowel cleanliness was as follows: very good — 30 (22.1%) patients, satisfactory — 97 (71.3%), and poor — 9 (6.6%). A positive correlation was observed between the degree of SB cleanliness and the SB transit time (p = 0.015). A longer SB transits time was associated with poor SB cleanliness. The results obtained in this study showed that the quality of SB cleanliness is affected by SB transit time. A relatively large percentage of cases rated as satisfactory bowel cleanliness and comparatively small percentage of bowel cleanliness cases rated as “very good” were observed when 2 litres of PEG were used prior to CE, indicating an important issues in preparation of the bowel prior to CE.

Objective measurement of effectiveness of psychological consulting services

2016 ◽  
Vol 44 (10) ◽  
pp. 1699-1717
Author(s):  
Yong-Hui Li ◽  
Guangxing Xu ◽  
Ya-Ting Chen
Keyword(s):  
Pupil Size ◽  
Vital Signs ◽  
Physiological Signals ◽  
Subjective Ratings ◽  
Consulting Services ◽  
Paired Samples ◽  
Psychological Consultation ◽  
Before And After ◽  
Consultation Session

We investigated whether or not physiological signals reflect the effectiveness of a psychological consultation. Participants (N = 108 college students) rated the quality of a consulting service. We recorded their vital signs before and after the consultation session, and eye-related signals during the consulting process. Results of paired samples t tests showed that body temperature, heart rate, and blood pressure had changed significantly after the consultation and degree of the changes was closely correlated with the participants' subjective ratings. Further, results of a 1-way analysis of variance showed that the change in eye-blinking rate and frequency of pupil size fluctuation were aligned with the consulting session outcome. Our results indicate that vital signs and eye-related signals are effective measures to evaluate the effectiveness of psychological consulting services.

scholarly journals The Effectiveness, Tolerability, and Safety of Different 1-Day Bowel Preparation Regimens for Pediatric Colonoscopy

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Anna Szaflarska-Popławska ◽  
Dominika Tunowska ◽  
Ola Sobieska-Poszwa ◽  
Anna Gorecka ◽  
Aneta Krogulska
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Bowel Preparation ◽  
Similar Efficacy ◽  
Serious Adverse Events ◽  
Preparation Methods ◽  
Sodium Picosulphate ◽  
Bowel Cleansing ◽  
Patient Reported ◽  
Colonoscopy Preparation

Background. Currently, there is no generally accepted universal protocol for bowel preparation before colonoscopy in children. Aim. The aim of the study was to compare three different 1-day bowel preparation methods for a pediatric elective colonoscopy in terms of their efficacy, safety, and patient-reported tolerability. Material and Methods. The study was randomized, prospective, and investigator-blinded. All children aged 10 to 18 years consecutively referred to the tertiary pediatric gastroenterology unit were enrolled. The participants were randomized to receive polyethylene glycol 3350 combined with bisacodyl (PEG-bisacodyl group), or polyethylene glycol 4000 with electrolytes (PEG-ELS group), or sodium picosulphate plus magnesium oxide plus citric acid (NaPico+MgCit group). Bowel preparation was assessed according to the Boston Bowel Preparation Scale (BBPS). For patient tolerability and acceptability, questionnaires were obtained. Results. One hundred twenty-three children were allocated to three age- and sex-matched groups. All of the patients completed colonoscopies with visualization of the cecum. There was no difference among the groups for the mean BBPS score. A total of 73 patients (59.3%) experienced minor adverse events. No serious adverse events occurred in any group. Nausea was the only symptom more frequent in the PEG-ELS group compared to the NaPico+MgCit group (p=0.04), and apathy was the only symptom more frequent in PEG-bisacodyl than in the NaPico+MgCit group (p=0.04). All of the patients were able to complete 75% or more of the study protocol, and 85.4% were able to complete the full regimen. The acceptability was the highest in the NaPico+MgCit group with respect to the patient’s grade for palatability, low volume of the solution, and willingness to repeat the same protocol. Conclusion. All bowel cleansing methods show similar efficacy. However, because of the higher tolerability and acceptability profile, the NaPico+MgCit-based regimen appears to be the most proper for colonoscopy preparation in children.

scholarly journals Quality of Life among Patients with Chronic Venous Disease (CVD) as Measured by the VEINES-QOL/SYM and the EuroQol-5D-5L Questionnaires, A Descriptive-Comparative Design Study

2021 ◽  
pp. 56-71
Author(s):  
Cabahug, Reagan F. ◽  
Montalan, Gina L. ◽  
Yape, Irma Marie P. ◽  
Laurenciana, Maria Cristina M.
Keyword(s):  
Quality Of Life ◽  
Similar Efficacy ◽  
Health Condition ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Quality Life ◽  
Before And After ◽  
Euroqol 5D ◽  
Sensitivity Specificity

Objective: To determine the efficacy (sensitivity, specificity, and accuracy) of the VeinesQol/Sym with metric statements fewer than the EQ5D in detecting the quality of life of patients with Chronic Venous Disease (CVD) before and after treatment. Methods: This is a descriptive-comparative design in collecting the necessary data to arrive at conclusions that respond to the specific questions of the study in 2 private hospitals. The responses gathered from patients through EQ5D and VeinesQol/Sym, before and after they received treatment were utilized in describing and comparing the efficacy of the health questionnaires.  Data were further subjected to a comparative analysis to elaborate the efficacy of the VeinesQol/Sym.  Results: A total of 114 CVD patients completed the study after the exclusion of 13 patients due to failure to follow up after eight weeks of treatment. The study showed that VeinesQol/Sym and EQ5D has similar efficacy in determining quality of life of CVD patients. However, VeinesQol/Sym  has higher accuracy (84.96% vs 76.99%), higher sensitivity (87.85% vs 83.87%), detects greater level of impairment in mobility, anxiety/depression, pain and discomfort, disruptions in usual activity and lower quality of current state of health condition than EQ5D Conclusion: With the responses to the metric statements of the indicators of quality life in both VeinesQol/Sym and EQ5D, VeinesQol/Sym was found to have a greater efficacy in establishing the accurate status of quality of life of patients with CVD than the EQ5D.

scholarly journals Unusual, non-anaphylactic transfusion reactions associated with severe IgA and IgM deficiencies and anti-IgA

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S18-S19
Author(s):  
Denis Noubouossie ◽  
Marisa B Marques ◽  
R Chad Siniard ◽  
Jose L O Lima
Keyword(s):  
Back Pain ◽  
High Titer ◽  
Vital Signs ◽  
Abdominal Distension ◽  
Transfusion Medicine ◽  
Blood Products ◽  
Transfusion Requirements ◽  
Before And After ◽  
Anaphylactoid Reactions ◽  
Igm Deficiency

Abstract A few individuals with undetectable IgA develop anti-IgA, which is theorized to promote anaphylactic or anaphylactoid reactions to blood products. Here, we describe a recurrent, unusual reaction in a patient with no IgA or IgM, and anti-IgA present. The patient is a 49-year-old male with cirrhosis secondary to hepatitis C, who presented to the emergency department in January of 2014 with abdominal distension, leg swelling and dyspnea. He was severely anemic with a hemoglobin of 4.5 g/dL. Several minutes into a transfusion, he complained of chills, dyspnea and back pain. The transfusion was discontinued after &lt;10mL, and his symptoms resolved rapidly without further intervention. The patient’s blood pressure, heart rate and temperature before and after the reaction were 134/63 mmHg and 180/64 mmHg, 98 beats/minute (bpm) and 102 bpm, and 98.6⁰ F and 98.7⁰ F, respectively. A laboratory workup for hemolysis was negative pre- and post-transfusion and an “OK to transfuse” order was given if future blood products were indicated. The following day, another transfusion of PRBCs was stopped after &lt;75 mL due to similar symptoms, which again resolved rapidly; no vital signs changes or signs of hemolysis were noted. Because he was receiving other fluids concurrently with the PRBCs, it was recommended to transfuse future products slowly and to premedicate with furosemide. Although he tolerated three subsequent PRBC transfusions during the same admission, he developed the same clinical picture as soon as &lt;75mL of a platelet unit was started. At that time, unbeknownst to Transfusion Medicine, the primary care team ordered immunoglobulin levels and anti-IgA, and the results of these tests were entered into his electronic medical record (EMR) after discharge. Approximately six years later, the patient was readmitted following a fall and was found to be thrombocytopenic. After receiving &lt;30 mL of platelets, he developed back pain and headache and the transfusion was aborted. His wife informed the primary provider that her husband was IgA-deficient. When Transfusion Medicine was notified, a review of his EMR showed undetectable IgA (&lt;6 mg/dL: reference: 46-236 mg/dL) and IgM (&lt;25 mg/dL; reference 43-279 mg/dL) and mildly increased IgG (1787 mg/dL; reference 650-1643 mg/dL) from 2014. Additionally, a high-titer IgG anti-IgA (&gt;1000 U/mL; reference &lt;99 U/mL), had been reported. In lieu of these findings, we changed his transfusion requirements to issue only washed PRBCs and IgA-deficient platelets and plasma, but he has not required any blood products since the last reaction. While a definitive cause and effect has not been established, this case suggests that severe IgA- and IgM-deficiency with IgG anti-IgA may be associated with nonspecific symptoms even with the transfusion of small volumes (&lt;75 mL). To our knowledge, similar reactions have not been previously reported.

scholarly journals Contextual Autocomplete: A Novel User Interface Using Machine Learning to Improve Ontology Usage and Structured Data Capture for Presenting Problems in the Emergency Department

2017 ◽  
Author(s):  
Nathaniel R. Greenbaum ◽  
Yacine Jernite ◽  
Yoni Halpern ◽  
Shelley Calder ◽  
Larry A. Nathanson ◽  
...  
Keyword(s):  
Machine Learning ◽  
Emergency Department ◽  
User Interface ◽  
Vital Signs ◽  
Structured Data ◽  
Data Capture ◽  
Free Text ◽  
Presenting Problems ◽  
Before And After

AbstractObjectiveTo determine the effect of contextual autocomplete, a user interface that uses machine learning, on the efficiency and quality of documentation of presenting problems (chief complaints) in the emergency department (ED).Materials and MethodsWe used contextual autocomplete, a user interface that ranks concepts by their predicted probability, to help nurses enter data about a patient’s reason for visiting the ED. Predicted probabilities were calculated using a previously derived model based on triage vital signs and a brief free text note. We evaluated the percentage and quality of structured data captured using a prospective before-and-after study design.ResultsA total of 279,231 patient encounters were analyzed. Structured data capture improved from 26.2% to 97.2% (p<0.0001). During the post-implementation period, presenting problems were more complete (3.35 vs 3.66; p=0.0004), as precise (3.59 vs. 3.74; p=0.1), and higher in overall quality (3.38 vs. 3.72; p=0.0002). Our system reduced the mean number of keystrokes required to document a presenting problem from 11.6 to 0.6 (p<0.0001), a 95% improvement.DiscussionWe have demonstrated a technique that captures structured data on nearly all patients. We estimate that our system reduces the number of man-hours required annually to type presenting problems at our institution from 92.5 hours to 4.8 hours.ConclusionImplementation of a contextual autocomplete system resulted in improved structured data capture, ontology usage compliance, and data quality.

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