Update and review of diagnosing functional anorectal disorders – standardized protocol for high-resolution anorectal manometry and the London classification

2020 ◽  
Vol 99 (6) ◽  
pp. 249-257
Keyword(s):  
Treatment Plan ◽  
Structural Function ◽  
Anorectal Disorders ◽  
Anorectal Dysfunction ◽  
Examination Protocol ◽  
Standardized Protocol ◽  
Multidisciplinary Cooperation ◽  
Anorectal Pain ◽  
Detailed Medical History

Complex anorectal examination including a detailed medical history, physical proctological examination and evaluation of the sensorimotor and structural function of the anorectum is essential for the diagnosis and therapeutic management of functional anorectal dysfunction. The aim of the work is to provide an overview of diagnosing functional anorectal disorders according to the new update and consensus statement of the International Anorectal Physiology Working Group (IAPWG) with a focus on indications, a standardized examination protocol and introduction of the new London classification of anorectal dysfunction. The indications are: fecal incontinence, defecation disorders, functional pelvic (anorectal) pain, evaluation before an anorectal intervention and before planned delivery to assess the function of a previously traumatized anal sphincter. Standardization of the diagnosis and the evaluated data are the basis for multidisciplinary cooperation and determination of a treatment plan for each patient individually.

scholarly journals Clinical practice patterns in indirect peroral cholangiopancreatoscopy: outcome of a European survey

2021 ◽  
Vol 09 (11) ◽  
pp. E1704-E1711
Author(s):  
Pauline M.C. Stassen ◽  
Pieter Jan F. de Jonge ◽  
George J.M. Webster ◽  
Mark Ellrichmann ◽  
Arno J. Dormann ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Bile Duct ◽  
Online Survey ◽  
Practice Patterns ◽  
International Consensus ◽  
Clinical Practice Patterns ◽  
European Survey ◽  
Standardized Protocol ◽  
Pancreatic Duct Stones

Abstract Background and aims Indirect peroral cholangiopancreatoscopy (IPOC) is a relatively new diagnostic and therapeutic tool for biliopancreatic diseases. This international survey aimed to evaluate clinical practice patterns in IPOC among endoscopists in Europe. Methods An online survey was developed comprising 66 questions on the use of IPOC. Questions were grouped into four domains. The survey was sent to 369 endoscopists who perform IPOC. Results 86 respondents (23.3 %) from 21 different countries across Europe completed the survey. The main indications for cholangioscopy were determination of biliary strictures (85 [98.8 %]) and removal of common bile duct or intrahepatic duct stones (79 [91.9 %]), accounting for an estimated use of 40 % (interquartile range [IQR] 25–50) and 40 % (IQR 30–60), respectively, of all cases undergoing cholangioscopy. Pancreatoscopy was mainly used for removal of pancreatic duct stones (68/76 [89.5 %]), accounting for an estimated use of 76.5 % (IQR 50–95) of all cases undergoing pancreatoscopy. Only 13/85 respondents (15.3 %) had an institutional standardized protocol for targeted cholangioscopy-guided biopsy sampling. IPOC with lithotripsy was used as first-line treatment in selected patients with bile duct stones or pancreatic stones by 24/79 (30.4 %) and 53/68 (77.9 %) respondents, respectively. Conclusions This first European survey on the clinical practice of IPOC demonstrated wide variation in experience, indications, and techniques. These results emphasize the need for prospective studies and development of an international consensus guideline to standardize the practice and quality of IPOC.

scholarly journals Standardized protocol for determination of biohydrogen potential

MethodsX ◽  
2020 ◽  
Vol 7 ◽  
pp. 100754 ◽  
Author(s):  
Julián Carrillo-Reyes ◽  
Germán Buitrón ◽  
Iván Moreno-Andrade ◽  
Aida Cecilia Tapia-Rodríguez ◽  
Rodolfo Palomo-Briones ◽  
...  
Keyword(s):  
Standardized Protocol

Synchronous liver metastases of rectal cancer and the possibility of simultaneous resection

2019 ◽  
Vol 98 (10) ◽  
Keyword(s):  
Rectal Cancer ◽  
Liver Metastases ◽  
Optimal Timing ◽  
Medical Procedures ◽  
Invasive Approach ◽  
Synchronous Liver Metastases ◽  
Surgical Technology ◽  
Multidisciplinary Cooperation ◽  
Simultaneous Surgery

Treatment of metastatic rectal cancer and liver metastases continues to pose a major challenge. Synchronous liver metastases are present in up to one fifth of patients diagnosed with rectal carcinoma. Multidisciplinary cooperation is essential for determination of the consequent diagnostic and therapeutic plan. Only tight collaboration of experts from different medical fields allows for optimal timing of various medical procedures leading to a maximal benefit for the patient. Given the complexity of the problem, different specific methods and combinations thereof are applied in the course of the therapy, making the design of straightforward guidelines impossible. Since open surgery is complicated by the vastly distant locations of the rectum and liver, minimally invasive approach brings more perspectives in simultaneous surgery. A novel possibility of robotic and/ or laparoscopic surgery performed by two teams is currently being developed. Despite the progress in surgical technology, optimal strategy has not yet been established.

Breast cancer − medical oncology summary 2021

2021 ◽  
Vol 100 (4) ◽  
Keyword(s):  
Breast Cancer ◽  
Medical Oncology ◽  
Systemic Treatment ◽  
Treatment Plan ◽  
Systemic Disease ◽  
Individual Case ◽  
Phenotypic Characteristics ◽  
Therapeutic Success ◽  
Multidisciplinary Cooperation ◽  
Different Types

Today, breast cancer has actually become merely an umbrella term that encompasses several cancers with different types of genesis, different genomic and phenotypic characteristics, different needs for systemic treatment and different prognosis. Early diagnosis and good multidisciplinary cooperation, choice of a proper treatment sequence, good supportive treatment and psychological support of the patient are crucial for a therapeutic success. The surgeon plays an important role in the treatment plan of patients with breast cancer; nevertheless, breast cancer is a systemic disease and thus as a rule, surgery alone is usually not sufficient to manage even early stages of the tumor. Surgeons as members of a multidisciplinary team need to know basic information on systemic treatment of breast cancer and have an understanding of how oncologists think; only then it will possible to achieve multidisciplinary consensus as painlessly as possible in each individual case.

3D high-resolution anorectal manometry − selected case reports

2020 ◽  
Vol 99 (6) ◽  
pp. 282-288
Keyword(s):  
High Resolution ◽  
Anorectal Manometry ◽  
Case Reports ◽  
Treatment Plan ◽  
Diagnostic Technique ◽  
Individualized Treatment ◽  
Pathophysiological Mechanisms ◽  
Anorectal Disorders ◽  
Comprehensive Examination ◽  
The Individual

Presented selected case reports are focused on the individual cases of patients suffering from functional anorectal disorders. During the examination algorithm, the emphasis is on 3D high-resolution anorectal manometry, which is a useful diagnostic technique and helps to understand the pathophysiological mechanisms in the field of functional anorectal disorders. Thanks to a comprehensive examination an individualized treatment plan can be determined for each patient.

scholarly journals Toward a Harmonized and Standardized Protocol for the Determination of Total Hydroxytyrosol and Tyrosol Content in Virgin Olive Oil (VOO). The Pros of a Fit for the Purpose Ultra High Performance Liquid Chromatography (UHPLC) Procedure

Molecules ◽  
2019 ◽  
Vol 24 (13) ◽  
pp. 2429 ◽  
Author(s):  
Maria Z. Tsimidou ◽  
Nikolaos Nenadis ◽  
Aspasia Mastralexi ◽  
Maurizio Servili ◽  
Bojan Butinar ◽  
...  
Keyword(s):  
High Performance Liquid Chromatography ◽  
Liquid Chromatography ◽  
Olive Oil ◽  
High Performance ◽  
Virgin Olive Oil ◽  
Method Comparison ◽  
Elution Time ◽  
Standardized Protocol ◽  
Liquid Chromatographic

Τoward a harmonized and standardized procedure for the determination of total hydroxytyrosol and tyrosol content in virgin olive oil (VOO), the pros of a recently published in house validated ultra high performance liquid chromatography (UHPLC) protocol are discussed comparatively with those of other procedures that determine directly or indirectly the compounds hosted under the health claim on “olive oil polyphenols” (EC regulation 432/2012). Authentic VOOs were analyzed with five different liquid chromatographic separation protocols and 1H-NMR one in five different laboratories with expertise in VOO phenol analysis within three months. Data comparison indicated differences in absolute values. Method comparison using appropriate tools (Passing-Bablok regression and Bland Altman analyses) for all protocols vs. the UHPLC one indicated slight or statistically significant differences. The results were also discussed in terms of cost effectiveness, detection means, standard requirements and ways to calculate the total hydroxytyrosol and tyrosol content. Findings point out that the in-house validated fit for the purpose UHPLC protocol presents certain pros that should be exploited by the interested parties. These are the simplicity of sample preparation, fast elution time that increase the number of samples analyzed per day and integration of well-resolved peaks with the aid of only two commercially available external standards. Importance of correction factors in the calculations is stressed.

Novel Quantitative Methods for the Determination of Biomaterial Cytotoxicity

1992 ◽  
Vol 15 (3) ◽  
pp. 191-194 ◽  
Author(s):  
M.D. Smith ◽  
J.C. Barbenel ◽  
J.M. Courtney ◽  
M.H. Grant
Keyword(s):  
Cell Culture ◽  
Medical Devices ◽  
Mtt Assay ◽  
Quantitative Methods ◽  
Artificial Organs ◽  
Fluorimetric Assay ◽  
Standardized Protocol ◽  
Ht1080 Cells ◽  
Quantitative Results

Two novel methods for the determination of biomaterial cytotoxicity using cell culture are presented. The methods combine a standardized protocol for producing extracts from medical devices with either the established MTT assay or a new fluorimetric assay. The suitability of both methods for evaluating the toxicity of candidate materials was demonstrated by resolution of the differences in the toxic effects of serial dilutions of a PVC extract on BHK21 and HT1080 cells. The tests yield highly reproducible, quantitative results and can be applied to materials in the usual physical forms applicable to artificial organs.

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