ABSTRACT
Iodine is an essential element for thyroid hormone synthesis. Iodine disorders induced biological and/to clinical expression of thyroid dysfunction. Inappropriate iodine intake (by default or by excess) is worrying in terms of public health in France regarding the iodine deficiency and the frequency of iatrogen iodine overloads. Urinary iodine determination which generally implicates the use of a cerimetric method, is an useful tool to evaluate iodine intakes. In this study, we described the analytical aspects of a semiquantitative method of urinary iodine using a redox indicator, ferroin. This method allows the screening of iodine excess or deficiency in a short time (< 3 hours) with a good specificity and sensitivity. Since this assay does not require specific apparatus, it could be easily developed in clinical chemistry laboratories for the detection of inappropriate iodine intakes, and could be useful for prevention programs of iodine deficiency.
Subject(s)
Indicators and Reagents , Iodine , Mass Screening/methods , Phenanthrolines , Urinalysis/methods , Bias , Colorimetry/methods , Colorimetry/standards , Discriminant Analysis , Humans , Iodine/deficiency , Iodine/poisoning , Iodine/urine , Mass Screening/standards , Oxidation-Reduction , Reference Values , Sensitivity and Specificity , Severity of Illness Index , Temperature , Thiocyanates/urine , Time Factors , Urinalysis/standardsABSTRACT
PURPOSE: The aim of the study was to evaluate the results of management of acutely obstructed carcinoma of the left colon by emergency subtotal/total colectomy (STC) with immediate anastomosis without diversion. METHODS: STC was performed in 48 patients (mean age 72 years). Inclusion criteria were reasonable operative risk, resectable acutely obstructed carcinoma, massively-distended colon of dubious viability, signs of impending cecal perforation. RESULTS: Postoperative mortality was 6.2% (n = 3): 2 patients over 85 years of age died postoperatively as a result of cardiopulmonary complications: an 83 year-old female dies as a result of an anastomotic dehiscence. Morbidity was 12.4% (n = 6) including one fistula which recovered without surgery. There were 4 synchronous colon cancers. Six months after surgery, the mean daily stool frequency was 2 after STC, and 3 after TC. CONCLUSION: Emergency STC achieves in one stage relief of bowel obstruction and tumor resection by encompassing a massively distended and fecal-loaded colon with ischemic lesions, ensures restoration of gut continuity via a "safe" anastomosis and removes occasional synchronous carcinoma.
Subject(s)
Carcinoma/surgery , Colectomy/methods , Colonic Diseases/surgery , Colonic Neoplasms/surgery , Intestinal Obstruction/surgery , Adult , Aged , Aged, 80 and over , Anastomosis, Surgical , Carcinoma/complications , Cause of Death , Cecal Diseases/surgery , Colectomy/adverse effects , Colon/blood supply , Colonic Diseases/etiology , Colonic Neoplasms/complications , Defecation , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Intestinal Fistula/etiology , Intestinal Obstruction/etiology , Intestinal Perforation/surgery , Ischemia/surgery , Male , Middle Aged , Pulmonary Embolism/etiology , Surgical Wound Dehiscence/etiology , Treatment OutcomeABSTRACT
Twenty-three patients with volvulus of the caecum were operated on from 1982 to 1995. There were 17 men and 6 women, mean age 63 years. Preoperative diagnosis was obtained in 48% of the cases. A right hemicolectomy was performed in 22 cases with immediate anastomosis; in one case, a double ilial and transverse stomy was required. Necrosis was observe in 12 patients (52%). Post-operative mortality was 8.6% (n = 2) due to circulatory shock in 2 patients with necrosis of the colon. Post-operative morbidity was 21% (n = 5) including one case with fistulization of the anastomosis requiring a double stomy. On the basis of this series and a review of the literature, it appears that right hemicolectomy is the treatment of choice for volvulus of the right colon, as it avoids all risk of recurrence and mortality is lower than conservative treatment.