Evaluation of a solid bolus suitable for esophageal scintigraphy.

This study was designed to select a suitable solid bolus for esophageal scintigraphy. Optimally, a bolus should leave minimal residual buccal and pharyngeal activity after being swallowed. We compared the oropharyngeal behavior of three boluses, i.e., omelette, egg white, and paté of 1- and 3-ml volume. Thirty patients without dysfunction of the upper esophageal sphincter were recruited for the study. Scintigraphy interpretation was based on the results of condensed images and time activity curves. A total of 108 oropharyngeal transits were analyzed. First we determined the most appropriate volume (1 or 3 ml) of paté, omelette, and egg white (i.e., the volume with the least residual oropharyngeal activity). Buccal or pharyngeal bolus retention occurred significantly less frequently with 1 ml paté than 3 ml (p = 0.03) and also less frequently with 3 ml egg white than with 1 ml egg white (p = 0.03), and the mean buccal bolus retention index was lower using 3 ml omelette than 1 ml omelette (p = 0.03). Then we identified the most suitable of the three selected boluses. Both oral and pharyngeal residues were higher for paté (1 ml) than for omelette (p = 0.02 and 0.05), and pharyngeal residue was significantly lower for omelette (3 ml) than for egg white (3 ml) (p = 0.02). In conclusion, a 3-ml bolus of radiolabeled omelette seems to be the most suitable bolus for exploration of esophageal transit, and its use could enhance the potential of scintigraphy in the assessment of esophageal disorders.

Disposal of injection material used for the treatment of hepatitis C: comparison with insulin-dependent diabetes and thromboembolism.

AIM: The survey conducted in the Provence-Alpes-Cote d'Azur region in France in 1999 showed that 38% of patients infected with the hepatitis C virus (HCV) receiving interferon injections in their home were aware of the recommendations concerning the disposal of injection material and that 41% of the needles were discarded with household waste after use. The purpose of our study conducted in the Centre region of France was to ascertain how injection material used by HCV-positive patients for interferon treatment are disposed of in comparison with material used by patients injecting insulin for insulin-dependent diabetes mellitus (IDDM) or low-molecular-weight heparin (LMWH) for thromboembolism. MATERIAL AND METHODS: A questionnaire to be completed by patients was proposed to HCV-positive patients attending hepatogastroenterology clinics in the Centre region hepatitis C network for therapeutic follow-up (N=113 patients) between October 2001-January 2002. The same questionnaire was proposed to patients attending follow-up consultations for insulin-dependent diabetes mellitus (N=85 patients) or thromboembolism (N=23 patients) between March-June 2002. RESULTS: Significantly more patients stated they were aware of recommendations for disposal of injection material in the HCV group (89%) than in the IDDM (67%) or LMWH (26%) groups (P<0.01). Injection material was discarded with household waste less often by patients in the HCV group (6%) than in the IDDM (32%) or LMWH (29%) groups (P<0.001) and more often collected in a safety box prior to incineration (73% in the HCV group versus 63% and 14% in the IDDM and LMWH groups respectively). The safety box was discarded with household garbage more often by patients in the IDDM (54%) or LMWH (50%) groups than in the HCV group (0%) (P<0.001). Equivalent proportions of the patients said they recapped the needle after use (HCV 83%; IDDM 93%; LMWH 84%). DISCUSSION: Information concerning use of safety boxes for disposal of injection material should be provided to patients in order to comply with regulatory recommendations on proper disposal of used injection material. Moreover, the habit of recapping needles (89% of all patients in this study) is still widespread.