Appendectomy has been shown to protect against the development of ulcerative colitis. The objecti... more Appendectomy has been shown to protect against the development of ulcerative colitis. The objective of this study was to examine the effect of appendectomy on the clinical features and natural history of colitis. A total of 259 consecutive adults patients with ulcerative colitis were studied. Of the patients, 20 had undergone appendectomy (12 before onset of colitis and eight after diagnosis). The frequency of appendectomy was significantly less than in a group of 280 controls, which comprised partners of the patients and a group from the community (OR = 0.25; 95% CI = 0.14-0.44). This was even more significant if only the 12 patients who underwent surgery before the onset of colitis were considered (OR = 0.15; 95% CI = 0.07-0.28). Patients with prior appendectomy developed symptoms of ulcerative colitis for the first time at a significantly later age than those without appendectomy (42.5 +/- 6.5 vs 32.1 +/- 0.8 yr; p < 0.01) or those who had appendectomy after the onset of colit...
Background: Post-liver-transplant biliary anastomotic strictures (ASs) are currently managed with... more Background: Post-liver-transplant biliary anastomotic strictures (ASs) are currently managed with repeated endoscopic retrograde cholangiopancreatographies (ERCPs) inserting multiple plastic stents. Fully covered self-expanding metal stents (FCSEMSs) are being increasingly reported in the management of this condition, however no prospective randomized trials have been performed to date. Aim: The aim of this study was to determine whether FCSEMSs decrease overall numbers of ERCPs needed to achieve stricture resolution and to establish the safety, efficacy and costeffectiveness in this setting. Methods: Two tertiary referral centres performed this open-label prospective randomized trial. A total of 32 patients consented and subsequently 20 were randomized with 10 in the FCSEMS arm and 10 in the plastic arm. The FCSEMS arm had the stent in situ for 12 weeks with the plastic stent arm undergoing 3-monthly multiple plastic stenting with or without dilatation over a year. Results: The median number of ERCPs performed per patient in the FCSEMS was 2 versus 4.5 (p = 0.0001) in the plastic stenting arm. Stricture resolution was achieved in all 10 patients with FCSEMSs compared with 8/10 in the plastic arm [p = not significant (NS)]. Complications occurred in 1/10 patients in the FCSEMS arm versus 5/10 in the plastic arm (p = 0.051). Days in hospital for complications was 6 in the FCSEMS versus 56 in the plastic arm (p = 0.11). Cost analysis shows that the FCSEMS arm was more cost effective. No cases of FCSEMS migration were seen. Conclusions: FCSEMSs reduced the number of ERCPs needed to achieve stricture resolution with similar recurrence rates between arms. The FCSEMSs may do so with fewer complications making it cost effective.
POSTERS system. Hence, low levels of actin-free Gc-globulin (AfGc) may serve as a prognostic mark... more POSTERS system. Hence, low levels of actin-free Gc-globulin (AfGc) may serve as a prognostic marker of survival in acute liver failure (ALF). Aim: To evaluate the prognostic value of AfGc in paediatric ALE Patients and Methods: Serum AfGc levels were measured using a rapid ELISA kit (Antibody Shop, Gentofte, Denmark) at admission in 115 children (60 male, median age 5.05 years, range 0 17.4) with ALF (INR>2 unresponsive to vitamin K and abnormal liver enzymes). Causes of ALF were: autoimmune hepatitis (10), drug-induced (16), haemophagocytic lymphohistiocytosis , hypoxia (4), viral hepatitis , metabolic , neonatal haemochromatosis , veno-occlusive disease (2), Wilson disease (6), idiopathic (41). Fifty-eight patients survived with medical treatment only (Group 1); 20 died (Group 2); 37 were transplanted, of whom 26 survived (Group 3) and 11 died (Group 4). Results: AfGc levels (gg/ml) were: Group 1: median 255 (range 0.2 525); Group 2:105 (0.1 365); Group 3:95 (0.1 355); Group 4:85 (0.1~70), values being significantly higher in Group 1 when compared to Group 2 (p 0.002) and to all the children who died or required transplantation taken together (p 0.00001). At a cut-off level of 190 gg/ml (obtained by plotting a receiver operative characteristic curve; the value of the area under the curve being 0.79), sensitivity and specificity for predicting survival with native liver were 85% and 62% respectively. Conclusions: These results show that AfGc levels on admission are of prognostic importance in children with ALE Prospective studies with serial measurements are necessary to further elucidate the accuracy and practical value of this test.
evaluate the difference between the calculated and real adenoma detection rate. Results: We retro... more evaluate the difference between the calculated and real adenoma detection rate. Results: We retrospectively evaluated 7011 colonoscopies performed by 37 staff gastroenterologists. The average adenoma detection rate for all indications, all age groups and both genders was 0.376 (range 0.22-1.0, standard deviation 0.19). The average adenoma to polyp detection rate was 0.61 (range 0.39-0.91, standard deviation 0.12). There was no statistically significant difference between the calculated adenoma detection rate and the real adenoma detection rate (pϭ0.39).Conclusions: These data suggest that it is possible to calculate a constant multiplier to estimate adenoma detection rate from polyp detection rate. However, further study is needed to determine if such a constant is present between practices and amongst different patient populations and procedural indications. 587i Pan-Chromocolonoscopy (PCC) vs. Narrow Band Imaging (NBI) in Colorectal Polyps Screening: A Prospective Randomized Study Sergey Kashin, Dmitry Zavyalov INTRODUCTION:
Coral tumors are atypical skeletal forms found on coral reefs worldwide. Here we present an analy... more Coral tumors are atypical skeletal forms found on coral reefs worldwide. Here we present an analysis of the microbial communities associated with skeletal tumors on the coral Porites compressa. Microbial growth rates on both healthy and tumorous P. compressa were decoupled from the surrounding water column. Microbial communities associated with tumorous colonies had a significantly faster growth rate than those associated with healthy P. compressa. The microbial community associated with the tumors contained more culturable Vibrio spp. and could utilize more carbon sources than the microbes associated with healthy colonies. Presence of tumors affected the composition and dynamics of the microbial population associated with the entire colony.
Appendectomy has been shown to protect against the development of ulcerative colitis. The objecti... more Appendectomy has been shown to protect against the development of ulcerative colitis. The objective of this study was to examine the effect of appendectomy on the clinical features and natural history of colitis. A total of 259 consecutive adults patients with ulcerative colitis were studied. Of the patients, 20 had undergone appendectomy (12 before onset of colitis and eight after diagnosis). The frequency of appendectomy was significantly less than in a group of 280 controls, which comprised partners of the patients and a group from the community (OR = 0.25; 95% CI = 0.14-0.44). This was even more significant if only the 12 patients who underwent surgery before the onset of colitis were considered (OR = 0.15; 95% CI = 0.07-0.28). Patients with prior appendectomy developed symptoms of ulcerative colitis for the first time at a significantly later age than those without appendectomy (42.5 +/- 6.5 vs 32.1 +/- 0.8 yr; p < 0.01) or those who had appendectomy after the onset of colit...
Background: Post-liver-transplant biliary anastomotic strictures (ASs) are currently managed with... more Background: Post-liver-transplant biliary anastomotic strictures (ASs) are currently managed with repeated endoscopic retrograde cholangiopancreatographies (ERCPs) inserting multiple plastic stents. Fully covered self-expanding metal stents (FCSEMSs) are being increasingly reported in the management of this condition, however no prospective randomized trials have been performed to date. Aim: The aim of this study was to determine whether FCSEMSs decrease overall numbers of ERCPs needed to achieve stricture resolution and to establish the safety, efficacy and costeffectiveness in this setting. Methods: Two tertiary referral centres performed this open-label prospective randomized trial. A total of 32 patients consented and subsequently 20 were randomized with 10 in the FCSEMS arm and 10 in the plastic arm. The FCSEMS arm had the stent in situ for 12 weeks with the plastic stent arm undergoing 3-monthly multiple plastic stenting with or without dilatation over a year. Results: The median number of ERCPs performed per patient in the FCSEMS was 2 versus 4.5 (p = 0.0001) in the plastic stenting arm. Stricture resolution was achieved in all 10 patients with FCSEMSs compared with 8/10 in the plastic arm [p = not significant (NS)]. Complications occurred in 1/10 patients in the FCSEMS arm versus 5/10 in the plastic arm (p = 0.051). Days in hospital for complications was 6 in the FCSEMS versus 56 in the plastic arm (p = 0.11). Cost analysis shows that the FCSEMS arm was more cost effective. No cases of FCSEMS migration were seen. Conclusions: FCSEMSs reduced the number of ERCPs needed to achieve stricture resolution with similar recurrence rates between arms. The FCSEMSs may do so with fewer complications making it cost effective.
POSTERS system. Hence, low levels of actin-free Gc-globulin (AfGc) may serve as a prognostic mark... more POSTERS system. Hence, low levels of actin-free Gc-globulin (AfGc) may serve as a prognostic marker of survival in acute liver failure (ALF). Aim: To evaluate the prognostic value of AfGc in paediatric ALE Patients and Methods: Serum AfGc levels were measured using a rapid ELISA kit (Antibody Shop, Gentofte, Denmark) at admission in 115 children (60 male, median age 5.05 years, range 0 17.4) with ALF (INR>2 unresponsive to vitamin K and abnormal liver enzymes). Causes of ALF were: autoimmune hepatitis (10), drug-induced (16), haemophagocytic lymphohistiocytosis , hypoxia (4), viral hepatitis , metabolic , neonatal haemochromatosis , veno-occlusive disease (2), Wilson disease (6), idiopathic (41). Fifty-eight patients survived with medical treatment only (Group 1); 20 died (Group 2); 37 were transplanted, of whom 26 survived (Group 3) and 11 died (Group 4). Results: AfGc levels (gg/ml) were: Group 1: median 255 (range 0.2 525); Group 2:105 (0.1 365); Group 3:95 (0.1 355); Group 4:85 (0.1~70), values being significantly higher in Group 1 when compared to Group 2 (p 0.002) and to all the children who died or required transplantation taken together (p 0.00001). At a cut-off level of 190 gg/ml (obtained by plotting a receiver operative characteristic curve; the value of the area under the curve being 0.79), sensitivity and specificity for predicting survival with native liver were 85% and 62% respectively. Conclusions: These results show that AfGc levels on admission are of prognostic importance in children with ALE Prospective studies with serial measurements are necessary to further elucidate the accuracy and practical value of this test.
evaluate the difference between the calculated and real adenoma detection rate. Results: We retro... more evaluate the difference between the calculated and real adenoma detection rate. Results: We retrospectively evaluated 7011 colonoscopies performed by 37 staff gastroenterologists. The average adenoma detection rate for all indications, all age groups and both genders was 0.376 (range 0.22-1.0, standard deviation 0.19). The average adenoma to polyp detection rate was 0.61 (range 0.39-0.91, standard deviation 0.12). There was no statistically significant difference between the calculated adenoma detection rate and the real adenoma detection rate (pϭ0.39).Conclusions: These data suggest that it is possible to calculate a constant multiplier to estimate adenoma detection rate from polyp detection rate. However, further study is needed to determine if such a constant is present between practices and amongst different patient populations and procedural indications. 587i Pan-Chromocolonoscopy (PCC) vs. Narrow Band Imaging (NBI) in Colorectal Polyps Screening: A Prospective Randomized Study Sergey Kashin, Dmitry Zavyalov INTRODUCTION:
Coral tumors are atypical skeletal forms found on coral reefs worldwide. Here we present an analy... more Coral tumors are atypical skeletal forms found on coral reefs worldwide. Here we present an analysis of the microbial communities associated with skeletal tumors on the coral Porites compressa. Microbial growth rates on both healthy and tumorous P. compressa were decoupled from the surrounding water column. Microbial communities associated with tumorous colonies had a significantly faster growth rate than those associated with healthy P. compressa. The microbial community associated with the tumors contained more culturable Vibrio spp. and could utilize more carbon sources than the microbes associated with healthy colonies. Presence of tumors affected the composition and dynamics of the microbial population associated with the entire colony.
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