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Medical Sciences	100%

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Endoscopic factors in the diagnosis of colorectal dysplasia in chronic inflammatory bowel disease

INFLAMMATORY BOWEL DISEASES, Issue 5 2005
Murat Toruner MD
Abstract Background: Surveillance colonoscopy in inflammatory bowel diseases (IBDs) is advocated for early diagnosis of neoplasia but is imperfect because some patients develop cancer despite surveillance. We sought to determine if any endoscopic factors during surveillance colonoscopy were associated with the diagnosis of colorectal dysplasia before the development of cancer. Methods: We reviewed the Mayo Clinic endoscopic database and medical records of patients with IBD who underwent surveillance colonoscopy between January 2002 and November 2003. Associations were sought between endoscopic factors and the diagnosis of dysplasia. Among 635 IBD patients, 24 (3.8%) had flat dysplasia and 12 (1.9%) had IBD-related polypoid dysplasia. In 28 patients (4.4%), sporadic tubular adenoma was identified. Colonoscopies in which flat dysplasia was identified varied in duration from 7 to 81 minutes (median, 24.5 min) compared with 3 to 70 minutes (median, 22 min) for those in which dysplasia was not found. Results: Using logistic regression analysis, we found that every additional minute in total colonoscopy time increased the flat dysplasia diagnosis rate by 3.5% (P = 0.0157). There was a significant correlation between median surveillance colonoscopy duration per endoscopist and flat dysplasia diagnosis rate (P = 0.0066). The number of biopsies taken during the procedures with flat dysplasia ranged from 6 to 36 (median, 28) compared with 2 to 54 (median, 25) in those without flat dysplasia. There was no significant effect of biopsy number of dysplasia diagnosis. Conclusions: Our results show that the practice of surveillance colonoscopy varies greatly among endoscopists, and longer procedure duration is significantly associated with the likelihood of dysplasia diagnosis. [source]

Hyperbaric Oxygen Does Not Prevent Neurologic Sequelae after Carbon Monoxide Poisoning

ACADEMIC EMERGENCY MEDICINE, Issue 1 2002
Benjamin Gilmer MS
Abstract Delayed neurologic sequelae occur in up to 40% of severe carbon monoxide (CO) poisonings. Conflicting clinical data support the efficacy of hyperbaric oxygen (HBO) therapy in the acute treatment of CO poisoning. Objective: To determine whether oxygen therapy reduces neurologic sequelae after CO poisoning in mice. Methods: Male Swiss-Webster mice were exposed to CO at 1,000 ppm for 40 minutes and then 50,000 ppm until loss of consciousness (LOC) (4-9 additional minutes). Total time of both phases of CO exposure was 40-49 minutes. Treatment included HBO with 3 atmospheres (ATA) 100% oxygen, normobaric oxygen (NBO) with 1 ATA 100% oxygen, or ambient air 15 minutes after LOC. All animals underwent passive avoidance training and memory was assessed by measuring step-down latency (SDL) and step-up latency (SUL) seven days following CO exposure. Results: Carbon monoxide poisoning induced significant memory deficits (SDLCO= 156 sec; SULCO= 75%) compared with nonpoisoned (NP) animals (SDLNP= 272 sec; SULNP= 100%). Both HBO and NBO did not prevent these neurologic sequelae. Furthermore, no significant neurobehavioral differences were found between HBO and NBO. Histologic examination of the CA1 layer of the hippocampus for pyknotic cells showed significant damage from CO in the air-treated animals (9.6%) but not in the nonpoisoned animals (3.8%). No significant neuroprotection was seen histologically with NBO and HBO compared with ambient air. Conclusions: These results suggest that HBO is not effective in preventing neurologic sequelae in mice and that there is no benefit of HBO over NBO following severe CO neurotoxicity. [source]

The impact of state physical education requirements on youth physical activity and overweight

HEALTH ECONOMICS, Issue 12 2007
John Cawley
Abstract To combat childhood overweight in the US, which has risen dramatically in the past three decades, many medical and public health organizations have called for students to spend more time in physical education (PE) classes. This paper is the first to examine the impact of state PE requirements on student PE exercise time. It also exploits variation in state laws as quasi-natural experiments in order to estimate the causal impact of PE on overall student physical activity and weight. We study nationwide data from the Youth Risk Behavior Surveillance System for 1999, 2001, and 2003 merged with data on state minimum PE requirements from the 2001 Shape of the Nation Report. We find that high school students with a binding PE requirement report an average of 31 additional minutes per week spent physically active in PE class. Our results also indicate that additional PE time raises the number of days per week that girls report having exercised vigorously or having engaged in strength-building activity. We find no evidence that PE lowers BMI or the probability that a student is overweight. We conclude that raising PE credit requirements may make girls more physically active overall but there is not yet the scientific base to declare raising PE requirements an anti-obesity initiative for either boys or girls. Copyright © 2007 John Wiley & Sons, Ltd. [source]

3231: The effect of riboflavin mediated corneal crosslinking on corneal hydration

ACTA OPHTHALMOLOGICA, Issue 2010
G KONTADAKIS
Purpose To evaluate the primary effect of corneal collagen crosslinking on corneal hydration. Methods Twenty corneal buttons from freshly enucleated porcine eyes where immersed in riboflavin 0.1% in dextran 20% dilution for three hours in order for their hydration to reach an equilibrium. Corneal buttons where divided in two groups; the first group was stored in dark conditions while the other group was irradiated with UV radiation (390nm) for 30 minutes to stimulate collagen cross-linking according to the clinically applied protocol. After irradiation all corneas were immersed in dextran 20% solution for 30 additional minutes and subsequently weighted. Finally all corneal buttons were dehydrated for 48 hours in a desiccating oven set at 62Co and weighted again to obtain their dry mass. Hydration (%) of each button was calculated. Results were analyzed with non parametric tests. Results Irradiated group of corneas had statistically significant lower hydration than the non irradiated group. (p<0.05, Mann-Whitney Test). Mean hydration in the irradiated group was 71% and in the non-irradiated 75%. Conclusion Collagen crosslinking causes corneal dehydration that can be detected immediately after the procedure. This phenomenon may contribute to increased mechanical stiffness of the cornea. [source]