Annoyed with Haemorrhoids? Risks of the Emborrhoid Technique

Digestive Diseases and Sciences - Haemorrhoids, a common ailment afflicting mostly Western patients, can produce bothersome symptoms, in particular pain, pruritus, and bleeding. There is a wide...     

Polyethylene glycol‐based bowel preparation before colonoscopy for selected inpatients: A pilot study

OBJECTIVE

To evaluate the impact of a new same‐day, low‐dose 1‐L polyethylene glycol‐based (1‐L PEG) bowel preparation on the diagnostic rating of selected hospitalized patients and its tolerability, with risk factors for inadequate bowel preparation.

METHODS

A single‐center prospective pilot study was conducted with hospitalized patients scheduled for colonoscopy, presenting risk factors for poor bowel preparation, such as bleeding or subocclusive symptoms. The included patients were randomly divided in two groups, which received either a same‐day 1‐L PEG (group A) or a split‐dose 4‐L PEG (group B), and performed a colonoscopy within 4 h of the last dose.

RESULTS

In all, 44 inpatients [27 males; mean age 63.5 years (range 20–94 years)] were enrolled. Optimal bowel cleansing was reached in 64% and 55% (P = 0.64) of patients in groups A and B, respectively. The adenoma detection rate was 14% (group A) and 18% (group B) (P = 0.34). A valid diagnosis was reached in 38 (86%) of 44 patients (21 in group A and 17 in group B) after a mean hospitalization of 3 days for group A and 6 days for group B (P = 0.04).

CONCLUSIONS

Our data support the conclusion that the schedule protocol proposed in this study enables a clear diagnosis in most of the inpatients at high risk of poor bowel preparation and no statistical differences were found between the two groups in terms of successful bowel cleansing achieved. Therefore, the same‐day, low‐dose 1‐L PEG bowel preparation could be introduced for selected inpatients.     

Pesky Pesce: A Forgettable Fish Dinner with a Late Surprise,a Perianal Abscess

Digestive Diseases and Sciences - Clinical presentation after ingestion of foreign body is a common finding in surgical practice. Perianal sepsis due to a foreign body is, usually, secondary to...     

Role of a distal pocket in the catalytic O2 reduction by cytochrome c oxidase models immobilized on interdigitated array electrodes

Five iron porphyrins with different superstructures were immobilized on self-assembled-monolayer (SAM)-coated interdigitated-array (IDAs) gold–platinum electrodes. The selectivity of the catalysts i.e., limited formation of partially reduced oxygen species (PROS) in the electrocatalytic reduction of dioxygen, is a function of 2 rates: (i) the rate of electron transfer from the electrode to the catalyst, which is controlled by the length, and conjugation of the linker from the catalyst to the electrode and (ii) the rate of bound oxygen (superoxide) hydrolysis, which correlates with the presence of a water cluster in the gas-binding pocket influencing the rate of oxygen binding; these factors are controlled by the nature of the porphyrin superstructure. The structurally biomimetic Tris-imidazole model is the most selective.     

Endoscopic management of multiple large antral hyperplastic polyps causing gastric outlet obstruction

Gastric hyperplastic polyps are often asymptomatic and are found incidentally at upper endoscopy performed for unrelated reasons. Although they are considered a benign lesion, all symptomatic polyps should be removed for a more reliable histological diagnosis, resolution of symptoms and to prevent potential malignant transformation. In fact, there are no significant difference between pure gastric hyperplastic polyps and gastric hyperplastic polyps with neoplastic transformation in the number, location, or gross appearance of polyps. If symptomatic, patients usually complain of dyspepsia, heartburn, abdominal pain or upper gastrointestinal bleeding leading to anaemia. Complete or incomplete gastric outlet obstruction with intermittent symptoms, may rarely be caused by gastric hyperplastic polyps. We described the management of a rare case of intermittent gastric outlet obstruction caused by a large hyperplastic antral polyp prolapsing through the pylorus. Using hydroxypropylmethylcellulose, a new lifting agent, firstly from pyloric side, we obtained a reliable long-lasting submucosal cushion under the lesion which allowed a stable repositioning of the polyp in the gastric lumen without making additional infiltration during the endoscopic mucosal resection. Innovative lifting agents could significantly reduce the procedure time, but additional studies should be performed on this area to confirm preliminary results. Endoscopic mucosal resection not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves symptomatic treatment.     

Mental training in dental education

A dental degree programme is a complex combination not only just to acquire knowledge and skills but also to develop interpersonal skills. It is a challenge for both students and staff to conceptualise studies in larger entities and to emphasise learning as a process.
This project's general aim is to support student's development to become a self-guided critical expert. This goal may be achieved by developing creative and inspiring learning and assessment atmosphere for basic, specialist and continuous education. The specific aim is to create a personal e-portfolio program to facilitate utilisation of ICT based interaction and information, e.g. to document text, pictures, film and sound. The program is part of the assessment plan using e-portfolio both summatively and formatively. Intra- and Internet are utilised to build a common data bank also to secure teaching continuity.
The project plan was awarded the first prize in the ICT-for-teaching competition at the University of Helsinki. The work is done in co-operation by university and a private company. Project's pilot phase started on spring 2002 involving the first and third year students and their teachers. It continues for the fall term 2002 with two additional student groups. Participants have completed a questionnaire on their pre-project ICT skills and attitudes. Training has been planned and carried out accordingly. The students are given the opportunity to produce a variety of personal versions and their copies for later use.
We conclude that it is very important to widen learning assessment methods to support students' continuous development beyond undergraduate programme and to learn to benefit from ICT. E-portfolio used in this project is a digital platform for all these purposes. We are looking forward to collecting more data from our own institute and to working in close international co-operation .     

Interaction of nitric oxide with a functional model of cytochrome c oxidase

Cytochrome c oxidase (CcO) is a multimetallic enzyme that carries out the reduction of O2 to H2O and is essential to respiration, providing the energy that powers all aerobic organisms by generating heat and forming ATP. The oxygen-binding heme a(3) should be subject to fatal inhibition by chemicals that could compete with O2 binding. Near the CcO active site is another enzyme, NO synthase, which produces the gaseous hormone NO. NO can strongly bind to heme a(3), thus inhibiting respiration. However, this disaster does not occur. Using functional models for the CcO active site, we show how NO inhibition is avoided; in fact, it is found that NO can protect the respiratory enzyme from other inhibitors such as cyanide, a classic poison.