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Split-dose preparations

Chi-Liang Cheng, Nai-Jen Liu, Jui-Hsiang Tang, Yen-Lin Kuo, Hsiang-Ling Hung, Yi-Ning Tsui, Bai-Ping Lee, Cheng-Hui Lin
BACKGROUND: A 3-l polyethylene glycol (PEG) solution provided better bowel cleansing quality than a 2-l solution for outpatient colonoscopy. Predictors of suboptimal preparation using a 3-l PEG have not been previously reported. AIMS: To investigate the possible predictors of suboptimal bowel preparation using 3-l of PEG. METHODS: We analyzed a database of 1404 consecutive colonoscopies during a 27-month period at a community hospital. A split-dose PEG regimen was provided for morning colonoscopies, and a same-day PEG regimen was provided for afternoon colonoscopies...
October 21, 2016: Digestive Diseases and Sciences
Sean C Rice, Tina Higginbotham, Melanie J Dean, James C Slaughter, Patrick S Yachimski, Keith L Obstein
OBJECTIVES: Successful outpatient colonoscopy (CLS) depends on many factors including the quality of a patient's bowel preparation. Although education on consumption of the pre-CLS purgative can improve bowel preparation quality, no study has evaluated dietary education alone. We have created an educational video on pre-CLS dietary instructions to determine whether dietary education would improve outpatient bowel preparation quality. METHODS: A prospective randomized, blinded, controlled study of patients undergoing outpatient CLS was performed...
October 18, 2016: American Journal of Gastroenterology
Theodor Voiosu, Alina Tanțău, A Voiosu, Andreea Benguș, Cristina Mocanu, Bianca Smarandache, C Baicuș, Ioana Vișovan, B Mateescu
BACKGROUND: Optimal bowel preparation is one of the most important factors affecting the quality of colonoscopy. Several patient-related factors are known to influence the quality of bowel cleansing but randomized trials in this area are lacking. We aimed to compare an individualized bowel prep strategy based on patient characteristics to a standard preparation regimen. MATERIAL AND METHODS: We conducted an endoscopist-blinded multicenter randomized control-trial...
October 13, 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Emanuele Rondonotti, Alida Andrealli, Arnaldo Amato, Silvia Paggi, Clara Benedetta Conti, Giancarlo Spinzi, Franco Radaelli
Adenoma detection rate (ADR) is the most robust colonoscopy quality metric and clinical studies have adopted it as the ideal method to assess the impact of technical interventions. Areas covered: We reviewed papers focusing on the impact of colonoscopy technical issues on ADR, including withdrawal time and technique, second evaluation of the right colon, patient positional changes, gastrointestinal assistant participation during colonoscopy, water-aided technique, optimization of bowel preparation and antispasmodic administration...
October 5, 2016: Expert Review of Gastroenterology & Hepatology
Yue-Qi Wang, Qing-Ze Fan, Yan Liu, Hua Yue, Xiao-Wei Ma, Jie Wu, Guang-Hui Ma, Zhi-Guo Su
In this study, we developed the quaternized chitosan microgels without chemical crosslinking as an adjuvant of H5N1 split vaccine. The microgels with pH-sensitivity, positive surface charge and good biocompatibility, have been demonstrated in favor of enhancing both humoral and cellular immune response. However, the detailed mechanism of the chitosan-based microgels to enhance antigen specific immune responses remains unclear. Therefore, we prepared the quaternized chitosan microgels with well defined quaternization degrees (QDs, 20-80%) and particle sizes (800nm-5μm) by the premix membrane emulsification technique, and investigated the effect of quaternization degree (QD) and size on the adjuvanticity of microgels...
September 30, 2016: International Journal of Pharmaceutics
Christian Schulz, Joachim Müller, Joachim Sauter, Stephan Miehlke, Christoph Schmöcker, Dirk Hartmann, Peter Malfertheiner, Carlos Badiola
BACKGROUND AND AIMS: Split-dose regimens are generally recommended for bowel cleansers. However, other regimens still remain in the summary of product characteristics of some bowel cleansers in Europe. The aim of this study is to compare the efficacy and safety of a split-dose regimen of sodium picosulfate/magnesium citrate (SPMC) with a prior-day schedule (AM/PM). METHODS: Multicenter, randomized (EudraCT no. 2013-001620-20), endoscopist-blinded, parallel study, carried out in subjects 18 years or older undergoing elective colonoscopy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Yoon Suk Jung, Chang Kyun Lee, Chang Soo Eun, Dong Il Park, Dong Soo Han, Hyo Jong Kim
BACKGROUND: Minimal data exist regarding the use of low-volume purgatives for elderly (≥65 years) patients. We aimed to investigate the bowel-cleansing efficacy and patient tolerability of split-dose 2 liters (L)-polyethylene glycol with ascorbic acid (2L-PEGA) in elderly outpatients undergoing colonoscopy. METHODS: Patients who underwent morning colonoscopies were randomly assigned to one of 3 arms: single-dose 4L-PEG on the day before colonoscopy; split-dose 4L-PEG; or split-dose 2L-PEGA...
August 24, 2016: Digestion
Mehmet İbiş, İbrahim Koral Önal, Mehmet Arhan, Tarkan Karakan, Eylem Karatay, Özlem Gül Utku, Harun Erdal, İbrahim Doğan
BACKGROUND/AIM: The aim of this study was to investigate the efficacy of a through- the-scope sodium phosphate solution with completion colonoscopy on the same day as a salvage option for inadequate bowel preparation. MATERIALS AND METHODS: All participants were instructed to eat a low residual diet for 3 days before the scheduled colonoscopy and a clear liquid diet 18 h before the colonoscopy. The patients were asked to take split doses of an oral sennoside solution at 1800 and 2200 in the evening before the colonoscopy...
2016: Turkish Journal of Medical Sciences
Jalil Mahmwd Abdulla, Stephen Paul Rose, Alexander Mackay Mackenzie, Sonya Georgieva Ivanova, Genoveva Petrova Staykova, Vasil Radoslavov Pirgozliev
An experiment examined the effects of two field bean cultivar samples with different tannin contents, the effect of heat treatment (micronising) and the effect of dietary supplementation of a proprietary enzyme preparation containing tannase, pectinase, and xylanase activities on metabolisable energy (ME), total tract dry matter digestibility (DMD) and ether extract digestibility (EED), nitrogen retention (NR), tannin degradability, gastrointestinal tract (GIT) development, and endogenous mucin losses excretion in broiler chickens...
October 2016: Archives of Animal Nutrition
Marco Antonio Alvarez-Gonzalez, Juana A Flores-Le Roux, Agustin Seoane, Juan Pedro-Botet, Laura Carot, Agnés Fernandez-Clotet, Agnés Raga, Miguel A Pantaleon, Luis Barranco, Felipe Bory, Vicente Lorenzo-Zuñiga
: Background and study aims: Previous studies have reported that diabetes mellitus is an independent risk factor for inadequate bowel preparation. Current guidelines do not recommend a specific preparation for this patient population. The aims of this study were to assess the efficacy, safety, and tolerability of an adapted preparation protocol for colon cleansing in patients with type 2 diabetes mellitus. Patients and methods: This randomized, single-blind, parallel group, superiority trial compared a conventional bowel preparation protocol (CBP) with a diabetes-specific preparation protocol (DSP)...
August 4, 2016: Endoscopy
Rachid Mohamed, Robert J Hilsden, Catherine Dube, Alaa Rostom
Background. The efficacy of colonoscopy in detecting abnormalities within the colon is highly dependent on the adequacy of the bowel preparation. The objective of this study was to compare the efficacy, safety, and tolerability of PEG lavage and split-dose PEG lavage with specific emphasis on the cleanliness of the right colon. Methods. The study was a prospective, randomized, two-arm, controlled trial of 237 patients. Patients between the age of 50 and 75 years were referred to an outpatient university screening clinic for colonoscopy...
2016: Canadian Journal of Gastroenterology & Hepatology
Julia McNabb-Baltar, Alastair Dorreen, Hisham Al Dhahab, Michael Fein, Xin Xiong, Mike O' Byrne, Imene Ait, Myriam Martel, Alan N Barkun
We examine the impact of key variables on the likelihood of inpatient poor bowel preparation for colonoscopy. Records of inpatients that underwent colonoscopy at our institution between January 2010 and December 2011 were retrospectively extracted. Univariable and multivariable logistic regression models were fitted to assess the effect of clinical variables on the odds of poor preparation. Tested predictors included age; gender; use of narcotics; heavy medication burden; comorbidities; history of previous abdominal surgery; neurological disorder; product used for bowel preparation, whether or not the bowel regimen was given as split or standard dose; and time of endoscopy...
2016: Canadian Journal of Gastroenterology & Hepatology
David P Gerard, Diane B Foster, John L Holden, Jieun Kang, Manfred W Raiser
BACKGROUND: We assessed the efficacy and tolerability of 5 low-volume bowel preparations for colonoscopy. STUDY: We performed an investigator-blinded, randomized trial of 5 bowel preparations: 64 ounces of Gatorade and 306 or 357 g of PEG, both given the day prior; Gatorade and 306 g PEG, 2 L PEG-electrolyte solution with ascorbic acid, and sulfate solution, all 3 given as a split dose. One thousand outpatients consumed their preparation before a morning colonoscopy...
July 18, 2016: Journal of Clinical Gastroenterology
Nicholas Horton, Ari Garber, Henrietta Hasson, Rocio Lopez, Carol A Burke
OBJECTIVES: There are little data on bowel movement (BM) kinetics induced by bowel preparation. Whether single-dose (SID) or split-dose (SPD) regimens differ in terms of patient convenience is unclear. We compared BM kinetics, sleep and travel disruptions, and polyp detection rates in patients undergoing colonoscopy assigned to SID vs. SPDs. METHODS: Patients were randomly assigned to 2-L SID or SPD (SPD1 and SPD2) bowel preparations. Surveys were completed querying the onset, duration, cessation, and intensity of BMs, along with sleep and travel disruption en route to the endoscopy center...
September 2016: American Journal of Gastroenterology
Hyo-Joon Yang, Soo-Kyung Park, Dong Han Yeom, Geom-Seog Seo, Jee Hyun Kim, Jong Pil Im, Dong Il Park
BACKGROUND AND AIMS: The present study aimed to evaluate the non-inferiority of low volume oral sulfate (OSS) to 4-L polyethylene glycol (PEG) solutions administered in a split-dose regimen as bowel preparation for colonoscopy. The safety and tolerability were also compared between the two regimens. METHODS: In this prospective, randomized, single-blind, active-control, parallel group, and non-inferiority trial, consecutive outpatients and health checkup recipients aged 19 to 65 undergoing elective colonoscopy were enrolled to receive OSS or 4-L PEG in a split-dose regimen...
June 27, 2016: Journal of Gastroenterology and Hepatology
M Richena, C A Rezende
Morphological changes in hair surface are undesirable, since they cause shine loss, roughness increase and split ends. These effects occur more frequently in the cuticle, which is the outermost layer of the hair strand, and thus the most exposed to the environmental damages. Sunlight irradiation contributes significantly to these morphological alterations, which motivates the investigation of this effect on hair degradation. In this work, the influence of irradiation and hand-washing steps on the morphology of pigmented and non-pigmented hair cuticle was investigated using field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM)...
August 2016: Journal of Photochemistry and Photobiology. B, Biology
Vladimír Kojecký, Milan Dastych, Zdena Zádorová, Michal Varga, Jan Hajer, Milan Kment, Radek Kroupa, Magda Kunovská, Jan Matouš, Miroslav Mišurec, Aleš Hep, Bohuslav Kianička, Jiří Latta
INTRODUCTION: The good and safe bowel cleansing is key to the success of coloscopy. The standard preparation involves 4 l polyethylene glycol (PEG). Now the combination of PEG and ascorbic acid (PEGA) of half the volume is available. Besides the type of product also the time factors which are not clarified, play a role during the bowel preparation. The aim of the study was to compare the efficiency and tolerance of both the agents and evaluate the effect of the time regimen of preparation...
April 2016: Vnitr̆ní Lékar̆ství
John K Triantafillidis, Constantine Vagianos, George Malgarinos
Colonoscopy represents a very important diagnostic modality for screening for colorectal cancer, because it has the ability to both detect and effectively remove pro-malignant and malignant lesions. It is recommended by almost all international and national gastroenterology and cancer societies, as an initial screening modality or, following a positive fecal occult blood test, to be performed every 10 years in individuals of average risk starting from the age of 50. However, a significant problem is the so-called post-screening (interval) polyps and cancers found some years after the index colonoscopy...
September 2015: Indian Journal of Surgical Oncology
Chi-Liang Cheng, Nai-Jen Liu, Jui-Hsiang Tang, Yen-Lin Kuo, Cheng-Hui Lin, Yi-Ning Tsui, Bai-Ping Lee, Yun-Chiu Tai, Ming-Yao Su, Cheng-Tang Chiu
GOAL: To examine the residual gastric volume (RGV) in colonoscopy after bowel preparations with 3-L polyethylene glycol (PEG). BACKGROUND: Obstacles to high-volume bowel preparation by anesthesia providers resulting from concerns over aspiration risk are common during colonoscopy. STUDY: Prospective measurements of RGV were performed in patients undergoing esophagogastroduodenoscopy (EGD) and morning colonoscopy with split-dose PEG preparation, patients undergoing EGD and afternoon colonoscopy with same-day PEG preparation, and patients undergoing EGD alone under moderate conscious sedation...
May 19, 2016: Journal of Clinical Gastroenterology
F Radaelli, S Paggi, A Repici, G Gullotti, P Cesaro, G Rotondano, L Cugia, C Trovato, C Spada, L Fuccio, P Occhipinti, F Pace, C Fabbri, A Buda, G Manes, G Feliciangeli, M Manno, L Barresi, A Anderloni, P Dulbecco, F Rogai, A Amato, C Senore, C Hassan
OBJECTIVE: Although split regimen is associated with higher adenoma detection and is recommended for elective colonoscopy, its adoption remains suboptimal. The identification of patient-related barriers may improve its implementation. Our aim was to assess patients' attitude towards split regimen and patient-related factors associated with its uptake. DESIGN: In a multicentre, prospective study, outpatients undergoing colonoscopy from 8:00 to 14:00 were given written instructions for 4 L polyethylene glycol bowel preparation, offering the choice between split-dose and day-before regimens and emphasising the superiority of split regimen on colonoscopy outcomes...
April 19, 2016: Gut
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