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[PMID]:29391302
[Au] Autor:Aygün C
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.
[Ti] Título:Improving the quality of colonoscopy: Impact of efficient and safer preparation protocols and shorter waiting times.
[So] Source:Turk J Gastroenterol;29(1):4-6, 2018 01.
[Is] ISSN:2148-5607
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Mh] Termos MeSH primário: Catárticos
Colonoscopia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Cathartics)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.5152/tjg.2018.18003


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[PMID]:29390432
[Au] Autor:Lee JM; Lee JH; Kim ES; Lee JM; Yoo IK; Kim SH; Choi HS; Keum B; Seo YS; Jeen YT; Lee HS; Chun HJ; Um SH; Kim CD
[Ad] Endereço:Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
[Ti] Título:The safety and effectiveness of 2-liter polyethylene glycol plus ascorbic acid in patients with liver cirrhosis: A retrospective observational study.
[So] Source:Medicine (Baltimore);96(51):e9011, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The safety of bowel-cleansing agents is an important issue in clinical practice, especially in patients with chronic diseases. Although the safety and efficacy of polyethylene glycol (PEG) has been investigated in many studies, few studies on PEG plus ascorbic acid exist. In this study, we compared the safety of 2 bowel-cleansing agents for patients with liver cirrhosis: 2-liter PEG (2 L PEG) plus ascorbic acid versus 4-liter PEG (4 L PEG). We performed a retrospective study on colonoscopy in patients with liver cirrhosis. Patients referred for colonoscopy were divided into 2 groups: 2 L PEG plus ascorbic acid (n = 105) and 4 L PEG (n = 61). Safety was assessed by comparing the clinical factors and laboratory findings as follows: blood biochemistry, electrolytes, weight change, and bowel-cleansing quality. Serum electrolytes, laboratory findings, and body weight showed no significant change between the 2 groups. There was no significant change in clinical factors before and after bowel preparation in the PEG group or the PEG plus ascorbic acid group. The acceptability and compliance of patients was better in the 2 L PEG plus ascorbic acid than the 4 L PEG group. In subgroup analysis, patients with compensated or decompensated cirrhosis showed no increased risk of electrolyte imbalances after bowel preparation. Child-Pugh scores did not influence the outcome after bowel cleansing. Successful cleansing was mostly achieved in both groups. Our analysis showed that of the use of 2 L PEG plus ascorbic acid could be a safe choice for colonoscopy in patients with liver cirrhosis.
[Mh] Termos MeSH primário: Ácido Ascórbico/uso terapêutico
Catárticos/uso terapêutico
Cirrose Hepática
Polietilenoglicóis/uso terapêutico
[Mh] Termos MeSH secundário: Ácido Ascórbico/administração & dosagem
Ácido Ascórbico/efeitos adversos
Catárticos/administração & dosagem
Catárticos/efeitos adversos
Colonoscopia
Feminino
Seres Humanos
Masculino
Meia-Idade
Polietilenoglicóis/administração & dosagem
Polietilenoglicóis/efeitos adversos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Cathartics); 30IQX730WE (Polyethylene Glycols); PQ6CK8PD0R (Ascorbic Acid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009011


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[PMID]:27770378
[Au] Autor:Cheng CL; Liu NJ; Tang JH; Kuo YL; Hung HL; Tsui YN; Lee BP; Lin CH
[Ad] Endereço:Division of Gastroenterology, Department of Medicine, Evergreen General Hospital, 150 Huan-Zhong East Rd., Zhongli District, Taoyuan, 320, Taiwan. chiliang.cheng@gmail.com.
[Ti] Título:Predictors of Suboptimal Bowel Preparation Using 3-l of Polyethylene Glycol for an Outpatient Colonoscopy: A Prospective Observational Study.
[So] Source:Dig Dis Sci;62(2):345-351, 2017 02.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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. The level of bowel cleansing was prospectively scored according to the Boston Bowel Preparation Scale (BBPS). Possible predictors of suboptimal colon preparation, defined as a BBPS score <7, were analyzed using univariate statistics and multivariate logistic regression models. RESULTS: The mean age of the study population (46.7 % men) was 52.5 years (range 20-80 years, SD 11.1 years), and the majority of patients (77.6 %) underwent morning colonoscopies. A suboptimal bowel preparation was reported in 17.2 % of the observed colonoscopies. In the multivariate regression analysis, constipation (odds ratio [OR] 1.60, 95 % confidence interval [CI] 1.15-2.22), male gender (OR 1.68, 95 % CI 1.25-2.25), obesity (OR 1.76, 95 % CI 1.29-2.41), and inadequate (<80 %) PEG consumption (OR 5.4, 95 % CI 2.67-10.89) were independent predictors of a suboptimal colon preparation. CONCLUSIONS: This prospective study identified that constipation, male gender, obesity, and inadequate intake of PEG were significant risk factors for suboptimal bowel preparation using a 3-l PEG solution for outpatient colonoscopy. Interventions of optimized colonoscopy preparation should be targeted at these patient populations.
[Mh] Termos MeSH primário: Catárticos/administração & dosagem
Colonoscopia
Polietilenoglicóis/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Assistência Ambulatorial
Constipação Intestinal/epidemiologia
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Obesidade/epidemiologia
Razão de Chances
Estudos Prospectivos
Fatores de Risco
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Cathartics); 30IQX730WE (Polyethylene Glycols)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171212
[Lr] Data última revisão:
171212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-016-4343-7


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[PMID]:29112565
[Au] Autor:Anjum N; Ren J; Wang G; Li G; Wu X; Dong H; Wu Q; Li J
[Ad] Endereço:Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
[Ti] Título:A Randomized Control Trial of Preoperative Oral Antibiotics as Adjunct Therapy to Systemic Antibiotics for Preventing Surgical Site Infection in Clean Contaminated, Contaminated, and Dirty Type of Colorectal Surgeries.
[So] Source:Dis Colon Rectum;60(12):1291-1298, 2017 Dec.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Preoperative bowel preparation with or without oral antibiotics is controversial in terms of postoperative surgical site infections. OBJECTIVE: This study aimed to evaluate the efficacy of oral antibiotics as adjunct therapy to systemic antibiotics with mechanical bowel preparation for preventing surgical site infections in clean contaminated, contaminated, and dirty colorectal procedures. DESIGN: This was a single-center, prospective randomized study. SETTING: This study was conducted at the General Surgery Department at Jinling Hospital, Nanjing University, China, from July 15, 2014 to January 20, 2016. PATIENTS: Patients aged ≥18 years scheduled for abdominal surgery with clean-contaminated, contaminated, and dirty wounds were selected. INTERVENTIONS: Patients were randomly assigned to receive preoperative mechanical bowel preparation or mechanical bowel preparation with oral antibiotics. MAIN OUTCOMES: The primary outcome was the rate of surgical site infections. The secondary outcomes were extra-abdominal complications, duration of postoperative ileus, and readmission rate. RESULTS: Ninety-five patients were allocated to each group. Eight and 26 surgical site infections (8.42% vs 27.3 %, p = 0.004) occurred in the mechanical bowel preparation with oral antibiotics and mechanical bowel preparation groups. Thirteen extra-abdominal complications were reported: 6 in the mechanical bowel preparation with oral antibiotics group and 7 in the mechanical bowel preparation group (6.3% vs 7.3%, p = 0.77). Postoperative ileus duration did not differ between groups (p = 0.23). There were 4 readmissions in the mechanical bowel preparation group and none in the mechanical bowel preparation with oral antibiotics group (p = 0.04). On multivariable analysis, blood loss ≥500 mL (OR, 5.1; 95% CI, 1.27-20.4; p = 0.02), ASA score ≥3 (OR, 3.9; 95% CI, 1.2-12.5; p = 0.01), contaminated types (OR, 3.6; 95% CI, 1.5-8.6; p = 0.01), and administration of preoperative oral antibiotics (OR, 0.20; 95% CI, 0.06-0.60; p = 0.005) independently affected the incidence of surgical site infections. LIMITATIONS: This was a single-center study. CONCLUSION: Preoperative oral antibiotics, as adjunct therapy to systemic antibiotics and mechanical bowel preparation, significantly reduced surgical site infections and minimized the readmission rates in clean contaminated, contaminated, and dirty types of colorectal surgery. See Video Abstract at http://links.lww.com/DCR/A437.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Antibioticoprofilaxia
Cirurgia Colorretal
Complicações Pós-Operatórias/prevenção & controle
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Administração Oral
Catárticos/uso terapêutico
China
Feminino
Seres Humanos
Masculino
Meia-Idade
Readmissão do Paciente/estatística & dados numéricos
Complicações Pós-Operatórias/microbiologia
Cuidados Pré-Operatórios
Estudos Prospectivos
Infecção da Ferida Cirúrgica/microbiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cathartics)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171108
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000927


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[PMID]:29069003
[Au] Autor:Chen HB; Lian-Xiang P; Yue H; Chun H; Shu-Ping X; Rong-Pang L; Xiao-Zong W; Xiao-Lin L
[Ad] Endereço:aDepartment of Gastroenterology, Sanming First Hospital Affiliated to Fujian Medical University, Sanming bDepartment of Gastroenterology, Fujian Medical University Union Hospital, Fuzou cDepartment of Cardiology, Fu Wai Hospital of Chinese Academy of Medical Sciences of Peking Union Medical College, Peking, China.
[Ti] Título:Randomized controlled trial of 3 days fasting and oral senna, combined with mannitol and simethicone, before capsule endoscopy.
[So] Source:Medicine (Baltimore);96(43):e8322, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND STUDY AIMS: The approach to small bowel preparation before capsule endoscopy (CE) is still suboptimal. PATIENTS AND METHODS: One hundred eighty patients were randomly allocated to 3 groups. Patients in Group A took 250 mL 20% mannitol and 1 L 0.9% saline orally at 05:00 hours on the day of the procedure. In Group B the same preparation was taken at 20:00 on the day before, and at 05:00 on the day of CE; in addition, 20 mL oral simethicone was taken 30 minutes before CE. Group C was treated identically to Group B, except that the patients fasted for 3 days and took 3 g senna orally 3 times daily before CE. The length of bowel containing green luminal contents was assessed by ImageJ software and bowel cleanliness was evaluated by computed assessment of the cleansing score. RESULTS: Cleansing of the whole small bowel and the distal small bowel were significantly different between the 3 groups (χ = 22.470, P = .000; χ = 17.029, P = .000, respectively). There were also significant differences between the 3 groups in the length of small bowel and specifically the length of the distal small bowel containing green luminal contents (χ = 12.390, P = .000, χ = 15.141, P = .000, respectively), but not with regard to the proximal small bowel (χ = 0.678, P = .509). CONCLUSIONS: Three days fasting and oral senna, combined with 20% mannitol and simethicone, before CE, can reduce the effects of bile on the small bowel and improve small bowel cleansing, especially in the distal small intestine.
[Mh] Termos MeSH primário: Endoscopia por Cápsula
Catárticos/administração & dosagem
Intestino Delgado
Manitol/administração & dosagem
Extrato de Sena/administração & dosagem
Simeticone/administração & dosagem
[Mh] Termos MeSH secundário: Administração Oral
Adulto
Idoso
Endoscopia por Cápsula/efeitos adversos
Endoscopia por Cápsula/métodos
Esquema de Medicação
Jejum
Feminino
Gastroenteropatias/diagnóstico
Seres Humanos
Intestino Delgado/efeitos dos fármacos
Intestino Delgado/fisiopatologia
Masculino
Meia-Idade
Planejamento de Assistência ao Paciente
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Cathartics); 3OWL53L36A (Mannitol); 8013-11-4 (Senna Extract); 8050-81-5 (Simethicone)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008322


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[PMID]:29017918
[Au] Autor:Ji X; Liu X; Peng Y; Zhan R; Xu H; Ge X
[Ad] Endereço:Research Center of Chinese Herbal Resource Science and Engineering, Guangzhou University of Chinese Medicine, Guangzhou 510006, China; Key Laboratory of Chinese Medicinal Resource from Lingnan, Guangzhou University of Chinese Medicine, Ministry of Education, China.
[Ti] Título:Comparative analysis of methicillin-sensitive and resistant Staphylococcus aureus exposed to emodin based on proteomic profiling.
[So] Source:Biochem Biophys Res Commun;494(1-2):318-324, 2017 Dec 09.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Emodin has a strong antibacterial activity, including methicillin-resistant Staphylococcus aureus (MRSA). However, the mechanism by which emodin induces growth inhibition against MRSA remains unclear. In this study, the isobaric tags for relative and absolute quantitation (iTRAQ) proteomics approach was used to investigate the modes of action of emodin on a MRSA isolate and methicillin-sensitive S. aureus ATCC29213(MSSA). Proteomic analysis showed that expression levels of 145 and 122 proteins were changed significantly in MRSA and MSSA, respectively, after emodin treatment. Comparative analysis of the functions of differentially expressed proteins between the two strains was performed via bioinformatics tools blast2go and STRING database. Proteins related to pyruvate pathway imbalance induction, protein synthesis inhibition, and DNA synthesis suppression were found in both methicillin-sensitive and resistant strains. Moreover, Interference proteins related to membrane damage mechanism were also observed in MRSA. Our findings indicate that emodin is a potential antibacterial agent targeting MRSA via multiple mechanisms.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Proteínas de Bactérias/genética
Emodina/farmacologia
Expressão Gênica/efeitos dos fármacos
Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos
[Mh] Termos MeSH secundário: Proteínas de Bactérias/metabolismo
Catárticos/farmacologia
Biologia Computacional
Reposicionamento de Medicamentos
Perfilação da Expressão Gênica
Redes Reguladoras de Genes/efeitos dos fármacos
Staphylococcus aureus Resistente à Meticilina/genética
Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento
Staphylococcus aureus Resistente à Meticilina/metabolismo
Testes de Sensibilidade Microbiana
Proteômica
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Cathartics); KA46RNI6HN (Emodin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE


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[PMID]:28917345
[Au] Autor:Hassan C; Condorelli G; Repici A
[Ad] Endereço:Endoscopy and Cardiology Department, IRCCS Istituto Clinico Humanitas, Rozzano, Milano, Italy.
[Ti] Título:Bowel preparation for colonoscopy and hypokalemia: at the heart of the problem!
[So] Source:Gastrointest Endosc;86(4):680-683, 2017 10.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Colonoscopia
Hipopotassemia
[Mh] Termos MeSH secundário: Catárticos
Seres Humanos
Polietilenoglicóis
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Cathartics); 30IQX730WE (Polyethylene Glycols)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE


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[PMID]:28759612
[Au] Autor:Hilsden RJ; Bridges R; Dube C; Heitman SJ; Rostom A
[Ad] Endereço:Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
[Ti] Título:Scheduling rules for patients with diabetes mellitus that facilitate split-dosing improve the quality of bowel preparation for colonoscopy.
[So] Source:PLoS One;12(7):e0182225, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND & AIMS: An adequate bowel preparation for colonoscopy is best achieved by giving the cleansing regimen as a split-dose with the second dose given 4-6 hours before the procedure. This can be difficult to administer to diabetics who are preferentially scheduled for early morning procedures. We examined the impact on bowel preparation quality of scheduling diabetics for mid-morning (9:30 am or later) procedures rather than early morning procedures (7:30-9:00 AM) to facilitate a split-dose preparation. METHODS: Historical cohort study of 34,415 patients (1,805 diabetics) age 18-74 years without significant comorbidities who underwent an outpatient colorectal cancer screening-related colonoscopy either before (2013) or after (2014) a unit wide change in scheduling practices for diabetics. The primary outcome was the rate of inadequate bowel preparation. Secondary outcomes include the rate of procedures complete to the cecum, procedure duration and detection rates of polyps, any colorectal cancer screening-relevant lesion (adenoma, sessile serrated adenoma, large proximal hyperplastic polyp) and advanced adenomas. RESULTS: From 2013 to 2014, the proportion of diabetics with an inadequate bowel preparation decreased from 7.7% to 3.2% (95% confidence interval for the difference 2.2%-6.8%, P<0.00005). There was no significant change in the proportion of non-diabetics with inadequate preparation (2% in both years). There was no change in secondary outcomes in diabetics from 2013 to 2014. CONCLUSIONS: Preferentially scheduling diabetic patients later in the morning that more conveniently allowed for a split dose bowel preparation resulted in decreased rates of inadequate bowel preparation without disadvantaging other patients.
[Mh] Termos MeSH primário: Catárticos/administração & dosagem
Colonoscopia/efeitos adversos
Neoplasias Colorretais/diagnóstico
Complicações do Diabetes/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Agendamento de Consultas
Catárticos/efeitos adversos
Colonoscopia/métodos
Colonoscopia/normas
Neoplasias Colorretais/epidemiologia
Complicações do Diabetes/epidemiologia
Esquema de Medicação
Feminino
Seres Humanos
Intestinos/efeitos dos fármacos
Intestinos/fisiologia
Masculino
Meia-Idade
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cathartics)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182225


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[PMID]:28723744
[Au] Autor:Lee DW; Koo JS; Kang S; Kim SY; Hyun JJ; Jung SW; Yim HJ; Lee SW
[Ad] Endereço:Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
[Ti] Título:Association between bowel habits and quality of bowel preparation for colonoscopy.
[So] Source:Medicine (Baltimore);96(29):e7319, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The effectiveness of colonoscopy is highly dependent on the quality of bowel preparation. Although many studies have previously evaluated the role of cleansing methods and dosing regimens, few have examined the association between bowel habits and subsequent bowel preparation. Here, we aimed to evaluate the impact of bowel habits on the quality of bowel preparation.A total of 404 patients who underwent a total colonoscopy and completed a personal bowel habit questionnaire at Korea University Hospital between December 2012 and December 2013 were enrolled. The usual stool form of patients was classified into 7 categories according to the Bristol Stool Scale (BSS). The quality of bowel preparation was determined during colonoscopy according to the Ottawa Bowel Preparation Scale (OBPS). Segment scores of ≥3 or total OBPS scores of >7 were defined as poor bowel preparation.Poor bowel preparation was reported in 9.4% of observed colonoscopies. The odds ratio (OR) of poor bowel preparation being associated with infrequent bowel movements (<3/week) was 5.00 (95% confidence interval [CI], 1.91-13.1, P = .001). BSS types 1 and 2 tended to have an association with poor bowel preparation, but the association was statistically insignificant (OR: 2.38; 95% CI, 0.90-6.33, P = .082). After adjusting for age, sex, drinking, presence of diabetes mellitus, and bowel preparation regimen, infrequent bowel movement (<3/week) was still significantly associated with poor bowel preparation. When subdividing by colonic segment, it was significantly associated with poor bowel preparation in all segments.Infrequent bowel movement (<3/week) was significantly associated with poor bowel preparation.
[Mh] Termos MeSH primário: Colonoscopia
Defecação
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Fatores Etários
Catárticos/administração & dosagem
Constipação Intestinal
Feminino
Hábitos
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Melhoria de Qualidade
República da Coreia
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cathartics)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007319


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[PMID]:28690206
[Au] Autor:Ohman KA; Wan L; Guthrie T; Johnston B; Leinicke JA; Glasgow SC; Hunt SR; Mutch MG; Wise PE; Silviera ML
[Ad] Endereço:Department of Surgery, Washington University School of Medicine, St Louis, MO.
[Ti] Título:Combination of Oral Antibiotics and Mechanical Bowel Preparation Reduces Surgical Site Infection in Colorectal Surgery.
[So] Source:J Am Coll Surg;225(4):465-471, 2017 Oct.
[Is] ISSN:1879-1190
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgical site infections (SSI) are a common complication after colorectal surgery. An infection prevention bundle (IPB) was implemented to improve outcomes. STUDY DESIGN: A standardized IPB that included the administration of oral antibiotics with a mechanical bowel preparation, preoperative shower with chlorhexidine, hair removal and skin preparation in holding, antibiotic wound irrigation, and a "clean-closure" protocol was implemented in January 2013. Data from the American College of Surgeons NSQIP were analyzed at a single academic institution to compare pre-IPB and post-IPB SSI rates. In January 2014, a prospective database was implemented to determine compliance with individual IPB elements and their effect on outcomes. RESULTS: For the 24 months pre-IPB, the overall SSI rate was 19.7%. During the 30 months after IPB implementation, the SSI rate decreased to 8.2% (p < 0.0001). A subset of 307 patients was identified in both NSQIP and our prospective compliance databases. Elements of IPB associated with decreased SSI rates included preoperative shower with chlorhexidine (4.6% vs 16.2%; p = 0.005), oral antibiotics (3.4% vs 15.4%; p < 0.001), and mechanical bowel preparation (4.4% vs 14.3%; p = 0.008). Patients who received a full bowel preparation of both oral antibiotics and a mechanical bowel preparation had a 2.7% SSI rate compared with 15.8% for all others (p < 0.001). On multivariate analysis, full bowel preparation was independently associated with significantly fewer SSI (adjusted odds ratio 0.2; 95% CI 0.1 to 0.9; p = 0.006). CONCLUSIONS: Implementation of an IPB was successful in decreasing SSI rates in colorectal surgery patients. The combination of oral antibiotics with a mechanical bowel preparation was the strongest predictor of decreased SSI.
[Mh] Termos MeSH primário: Antibioticoprofilaxia
Catárticos/uso terapêutico
Doenças do Colo/cirurgia
Cuidados Pré-Operatórios
Doenças Retais/cirurgia
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Administração Oral
Adulto
Idoso
Antibacterianos/administração & dosagem
Protocolos Clínicos
Feminino
Seres Humanos
Laparoscopia
Masculino
Meia-Idade
Infecção da Ferida Cirúrgica/epidemiologia
Irrigação Terapêutica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cathartics)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE



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