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1.
Dig Dis Sci ; 67(4): 1231-1237, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34018071

RESUMO

INTRODUCTION: Inadequate bowel preparation has been associated with a higher likelihood of missing adenomatous polyps. Colonoscopies immediately following a weekend may be prone to inadequate bowel preparation. This study aims to evaluate if day of the week is a predictor of bowel preparation adequacy, while assessing other patient and procedural variables and their effect on the Boston Bowel Preparation Scale (BBPS). METHODS: A retrospective review was conducted of all adult patients undergoing outpatient colonoscopy between January 2015 and April 2020. Adequacy of bowel preparation was compared among all days of the week and days following federal holidays. Secondary outcomes included patient demographics, indication and timing of the procedure. RESULTS: Of 4,279 colonoscopies, Monday had the highest rate of inadequate preparation (BBPS < 6) (16.5%) compared to other days of the week (p < .001). Post-holiday procedures were not associated with poor bowel preparation (p = .901). Similarly, on multivariate analysis, we found that procedures on Monday (OR 1.67 95%CI 1.33-2.10, p < .001) and African-American race (OR 1.34 95%CI 1.11-1.62, p = .003) were associated with inadequate bowel preparation. Females were more likely to have adequate bowel preparation (OR 0.71 95%CI 0.59-0.86, p < .001). DISCUSSION: Bowel preparation on Mondays is more likely to be inadequate than other days of the week. Additionally, gender and ethnicity appear to be associated with quality of bowel preparation. A better characterization of procedural and patient variables can lead to a more personalized approach to bowel preparation.


Assuntos
Pólipos Adenomatosos , Pacientes Ambulatoriais , Adulto , Catárticos , Colonoscopia/métodos , Feminino , Humanos , Estudos Retrospectivos
3.
Inflamm Bowel Dis ; 26(10): 1607-1618, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32844174

RESUMO

BACKGROUND: Diagnosis and monitoring of inflammatory bowel diseases (IBDs) utilize invasive methods including endoscopy and tissue biopsy, with blood tests being less specific for IBDs. Substantial evidence has implicated involvement of the neurohormone serotonin (5-hydroxytryptamine, 5-HT) in the pathophysiology of IBDs. The current study investigated whether serum 5-HT is elevated in patients with active ulcerative colitis (UC) or Crohn's disease (CD). METHODS: Serum samples were obtained from a German cohort of 96 CD and UC patients with active disease, refractory disease, or remission of disease based upon their disease activity index (DAI) and disease history. High pressure liquid chromatography with tandemmass spectrometry was used to measure 5-HT, tryptophan (TRP), and kynurenine (KYN) levels in the serum samples, and Luminex Multiplex ELISA was used to measure cytokine levels. Intestinal mucosal biopsies were obtained from a separate cohort of healthy and CD patients, and the immunoreactivity of the serotonin transporter (SERT) was determined. RESULTS: There was no statistically significant difference in TRP or KYN levels between disease categories in either UC or CD. Interestingly, 5-HT levels were significantly elevated in patients with active CD but not active UC when compared with the levels in remission or refractory disease. Serum 5-HT was superior to C-reactive protein and circulating cytokines in differentiating between disease categories in CD. Additionally, SERT immunoreactivity was decreased in the ileum and colon of patients with CD compared to healthy controls. CONCLUSION: We have shown that the serum 5-HT can differentiate between active disease and refractory disease or remission among CD patients, emphasizing the potential suitability of serum 5-HT as an auxiliary measure in diagnosing active CD.


Assuntos
Colite Ulcerativa/sangue , Doença de Crohn/sangue , Serotonina/sangue , Índice de Gravidade de Doença , Adolescente , Adulto , Biópsia , Proteína C-Reativa/análise , Colite Ulcerativa/patologia , Colo/patologia , Doença de Crohn/patologia , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Íleo/patologia , Mucosa Intestinal/patologia , Cinurenina/sangue , Masculino , Pessoa de Meia-Idade , Triptofano/sangue , Adulto Jovem
4.
Surg Neurol Int ; 6: 171, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26629397

RESUMO

Amyotrophic lateral sclerosis (ALS) is a late-onset fatal neurodegenerative disease affecting motor neurons with an incidence of about 1/100,000. Most ALS cases are sporadic, but 5-10% of the cases are familial ALS. Both sporadic and familial ALS (FALS) are associated with degeneration of cortical and spinal motor neurons. The etiology of ALS remains unknown. However, mutations of superoxide dismutase 1 have been known as the most common cause of FALS. In this study, we provide a comprehensive review of ALS. We cover all aspects of the disease including epidemiology, comorbidities, environmental risk factor, molecular mechanism, genetic factors, symptoms, diagnostic, treatment, and even the available supplement and management of ALS. This will provide the reader with an advantage of receiving a broad range of information about the disease.

5.
P. R. health sci. j ; 11(1): 19-21, Apr. 1992. ilus
Artigo em Inglês | LILACS | ID: lil-107881

RESUMO

La actinomicosis primaria en el hígado es una entidad rara. Reportamos el caso de un joven con historial pasado de apendectomía, que presentó con fiebre, pérdida de peso y una masa hepática que incialmente se sospechó de índole neoplástica. Una biopsia hepática percutánea reveló la presencia de organismos parecidos a Actinomyces. El presente recibió tratamiento endovenoso y oral con Penicilina con buena respuesta clínica. Repasamos la literatura y consideramos la relación entre actinomicosis hepática y apendectomía previa


Assuntos
Abscesso Hepático/microbiologia , Actinomyces/isolamento & purificação , Actinomicose/microbiologia , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático , Actinomicose/tratamento farmacológico , Penicilinas/uso terapêutico , Tomografia Computadorizada por Raios X
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