Multicenter, randomized study to optimize bowel preparation for colon capsule endoscopy.

AIM: To assess the cleansing efficacy and safety of a new Colon capsule endoscopy (CCE) bowel preparation regimen. METHODS: This was a multicenter, prospective, randomized, controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system (PillCam® COLON 2; Medtronic, Yoqneam, Israel) was utilized. Preparation regimens differed in the 1st and 2nd boosts with the Study regimen using oral sulfate solution (89 mL) with diatrizoate meglumine and diatrizoate sodium solution ("diatrizoate solution") (boost 1 = 60 mL, boost 2 = 30 mL) and the Control regimen oral sulfate solution (89 mL) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety, polyp detection, colonic transit, CCE completion and capsule excretion ≤ 12 h. RESULTS: Both regimens had similar cleansing efficacy for the whole colon (Adequate: Study = 75.9%, Control = 77.3%; P = 0.88) and individual segments. In the Study group, CCE completion was superior (Study = 90.9%, Control = 76.9%; P = 0.048) and colonic transit was more often < 40 min (Study = 21.8%, Control = 4%; P = 0.0073). More Study regimen subjects experienced adverse events (Study = 19.4%, Control = 3.4%; P = 0.0061), and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen, but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract, from ingestion to excretion, was shorter with the Study regimen while mean colonic transit times were similar for both study groups. CONCLUSION: A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective, safe, and achieved superior CCE completion.

Diagnóstico serológico de la hepatitis viral / Serologic diagnosis of viral hepatitis

Las pruebas serológicas son el método más preciso para identificar la causa viral de una hepatopatía y para distinguir entre las diferentes formas de hepatitis viral. Aunque algunas características de la hepatitis viral tales como la vía de transmisión y el período de incubación pueden ayudar en el diagnóstico diferencial, rara vez son suficientes para establecer el diagnóstico definitivo. Los exámenes de laboratorio o la biopsia hepática a veces permite diferenciar entre las formas de hepatopatía, pero por lo general tampoco identifican la forma de hepatitis viral presente. No obstante, en pacientes con hepatitis crónica, la biopsia de hígado a menudo sirve para determinar la severidad de la enfermedad, establecer el pronóstico y, en algunos casos, orientar la terapia entiviral.