A Comparative Clinical Study of a Novel Pre-colonoscopy Bowel Capsule Preparation Against Two Commercially Available Liquid Preparations

Background and Aims: Colonoscopy surveillance depends on effective bowel preparation. Inadequate bowel preparation can lead to inaccurate clinical diagnosis, insufficient visualization of the colon and increased risk of missed diagnosis. This study aimed to compare the efficacy and safety of a novel Capsule Bowel Preparation (RitePrep), high-volume (2L) polyethylene glycol electrolyte solution (MoviPrep®) and low-volume (1L) polyethylene glycol electrolyte solution (Plenvu™).Methods: Patients (n = 120) were divided into three groups and were administered either RitePrep, MoviPrep® or Plenvu™ as a pre-colonoscopy bowel preparation followed by a colonoscopy at a single center. Validated Boston Bowel Preparation Score (BBPS) and bubble score were used to evaluate bowel cleanliness. Blood tests were also evaluated. The scores and the blood results were analyzed using Kruskal-Wallis and Chi-squared tests.Results: A total of 120 patients (median age of 55; 57 males) [RitePrep (n = 40), MoviPrep® (n = 40) and Plenvu™ (n = 40)] were included in the study. RitePrep was the most effective method for cleansing the bowel, with a significantly higher median BBPS compared to MoviPrep® and Plenvu™ (p = 0.006 and 0.024, respectively). Nearly 50% of the patients in Plenvu™ group showed increased serum osmolality disturbance. Nausea and vomiting were higher in Plenvu™ and MoviPrep® groups than RitePrep group.Conclusions: RitePrep was demonstrated to be a more effective and safe preparation than the other two preparations. RitePrep was not only well-tolerated by all patients; the preparation sufficiently cleared the ascending, transverse, and descending colon, enabling optimal visualization for the clinician. RitePrep was also much safer than the comparators, with no alteration in electrolytes measured. For both the clinician and the patient, RitePrep was the preferred preparation.

THE PROBLEM OF DEVELOPMENT OF MAXILLARY SINUSITIS AFTER SINUS-LIFTING SURGERY

Subject. In some clinical cases maxillary sinus lift is a nessesary surgery preparing for dental implantation in the distal parts of the upper jaw. However, despite the widespread using of this type of surgery in clinical practice, the percentage of postoperative complications leading to the development of odontogenic maxillary sinusitis after sinus-lifting surgery does not decrease from year to year. Among the complications of sinus lifting, the following main ones are distinguished: perforation of the maxillary sinus mucosa and nasal cavity; rejection of a previously installed dental implant; migration of the implant and/or bone material to the maxillary sinus; bleeding; acute maxillary sinusitis. The aim is to conduct a systematic analysis of domestic and foreign literature sources to determine the main factors of development of postoperative odontogenic sinusitis, as well as features of diagnosis and prevention of this complication. Methodology. The review of research allows us to consider the etiology of odontogenic maxillary sinusitis after sinus-lifting surgery and the pathogenesis of the disease, to draw conclusions about possible ways to prevent its development. Results. Odontogenic sinusitis that developed after the sinus-lifting operation is very common in clinical practice, despite the widespread use of this type of bone augmentation and proven methods of surgical intervention. The reason for this can be both anatomical prerequisites and iatrogenic factors, as well as insufficient diagnosis of pathologies of the paranasal sinuses in the preoperative period. Conclusions. The development of postoperative sinusitis can be avoided with careful planning of the operation, necessarily with computer tomography (preferably, cone-beam (dental) computed tomography, which is characterized by a relatively low load for optimal visualization of the maxillofacial tissues). Pathological changes in the sinus cavity and paranasal structures should be eliminated as planned before the sinus-lifting operation.

The endoluminal pressures during flexible gastrointestinal endoscopy

In flexible gastrointestinal (GI) endoscopy, endoscopic insufflation is crucial and directly affects visualization. Optimal visualization enables endoscopists to conduct better examinations and administer optimal treatments. However, endoscopic insufflation is typically performed manually and is subjective. We aimed to measure the GI endoluminal pressure during flexible GI endoscopy. Participants underwent esophagogastroduodenoscopy (EGD) at our endoscopy center. Pressure measurement was conducted after completing diagnostic or follow-up EGD. The endoluminal pressure in the esophagus and stomach was measured at 1-s intervals for 1 min while performing EGD for observational and diagnostic purposes. During the measurements, the endoscopists maintained what they subjectively considered to be adequate exposure for screening for lesions by dilating the lumen. Eighty patients were enrolled in this study. The upper GI endoluminal pressure was assessed during EGD without adverse events. The esophageal endoluminal pressure averaged 8.9 (− 3.0 to 20.7) mmHg, and the gastric endoluminal pressure averaged 10.0 (3.0–17.9) mmHg; the upper GI endoluminal pressures were not affected by patient-related factors or the number of endoscopists’ postgraduate years. We have successfully obtained the GI endoluminal pressures during EGD. Further accumulation of these data may lead to more stable and reproducible flexible endoscopic diagnosis and intervention.

Low back pain – literature review

Low back pain (LBP) is the third most common disorder presenting in the neurology outpatient clinic. It is usually defined as acute (less than 4 weeks), subacute (4–8 weeks) and chronic (more than 12 weeks). It is estimated that lifetime prevalence of up to 84 %. LBP is the most common cause of disability. LBP is divided into musculoskeletal and neurologic low back pain. In 90% of patients under the age of 65 the cause of pain is nerve root compression caused by disk herniation. Although serious spinal pathology is rare (less than 1%), the identification of red flags remains key in the evaluation of patients with LBP. A prior history of cancer, even in the absence of other red flags, has the highest predictive value for detection of malignancy. In conjunction with the history, a careful neurologic examination can help establish the presence and localize the lesion. According to guidelines imaging studies should not be obtained in patients with LBP of less than 6 weeks duration in the absence of red flags. Magnetic resonance imaging is the study of choice in patients with LBP. It allows for optimal visualization of the spinal cord, nerve roots and intervertebral discs. The results of MRI should be interpreted with caution because incidental degenerative spine changes unrelated to the pain are commonly seen in MRI. The main goals of treatment the patients presenting with acute LBP are reduction of pain and preservation of sensory and motor function. In the absence of red flags, for most cases conservative management will be appropriate. Prognosis are favorable, although recurrence rates range from 23% to 80%.

Systemic veins

Most contrast-enhanced scanning protocols of the thorax are designed to provide optimal visualization of the lungs, pulmonary arteries, heart, or aorta and its branches. Nevertheless, the systemic venous system is routinely imaged during CT examinations, but is often regarded as of secondary importance to the main indication for the scan. However, there are many clinical situations where the visualization of the systemic veins is of prime interest. These include assessment of SVC obstruction, IVC involvement, potential access routes for central venous line wire placement, and pre-operative assessment.

TONE COMPRESSION ALGORITHM FOR HIGH DYNAMIC RANGE MEDICAL IMAGES

<p><strong>Abstract.</strong> We propose here an HDR compression method for medical images based on a windowing operator, an adaptive tone mapping operator, and the probabilistic normal-gamma model. First, we use the windowing operator based on a structural fidelity measure for optimal visualization of the input HDR medical image. Then, we transform the windowed image to the logarithm domain and split it into base and detail layers with the help of the probabilistic normal-gamma model. Base and detail layers are used to make the tone map with help the adaptive tone mapping operator. Finally, the tone mapping result is the LDR image. The proposed method has comparable quality and low computation time compared to other tone mapping operators.</p>