Technical performance of colonoscopy -- multicenter study in university and non-university centers of Romania.

UNLABELLED: The aim of the paper was to evaluate the national availability of colonoscopy and the quality parameters of this procedure in our country. MATERIAL AND METHOD: During a 6 months period (01.07- 31.12.2009), we performed a prospective multicenter study in which 76 centers were invited to respond to a questionnaire regarding colonoscopy, 39 centers agreeing to participate. We assessed: the number of colonoscopies, the number of total colonoscopies and the causes of incomplete colonoscopies. RESULTS: During the study period, 16,083 colonoscopies were performed, 12,294 (76.4%) of them total colonoscopies. In 1,191 cases, stenosis was the cause of incomplete colonoscopy. If we consider this an objective reason for an incomplete colonoscopy, there were 12,294 total colonoscopies (82.4%). Comparing university centers with non-university ones, the proportion of total colonoscopies was 10,400/12,475 (83.4%) vs. 1,894/2,417 (78.4%) (p less then 0.0001). However, comparing the present study with previous ones, performed in 2003 and 2007, the proportion of total colonoscopies increased from 70.5% to 76.9% and 82.4% respectively (2003 vs. 2007 p less then 0.0001; 2007 vs. 2009 p less then 0.0001), while the quality difference between university and non-university hospitals persisted. CONCLUSIONS: the quality of colonoscopy in Romania increased in the last 5 years, while the quality difference between university and non-university hospitals persisted.

Rifaximin modulates 5-fluorouracil-induced gastrointestinal mucositis in rats.

OBJECTIVE: This study assessed the protective potential of rifaximin in 5-fluorouracil (5-FU) induced intestinal mucositis in the Wistar rats'. MATERIALS AND METHODS: Twenty-nine Wistar rats were divided into 4 interventional groups of 6 animals (A, B, C and F) and one control group (M) of 5 animals. Groups A, B and C received for three days consecutively rifaximin orally: 50 mg/kg (group A), 100 mg/kg (group B) and 200 mg/kg (group C). In the fourth day, 500 mg/kg of 5-FU was administered intraperitoneally to the groups A, B, C and F. A semi-quantitative histological assessment for duodenum, jejunum and colon were obtained by rating 11 histological characteristics of mucositis from 0 (normal) to 3 (severe). Semi-quantitative grades were a measure for TLR4 immunopositive cells. Statistical comparisons used - U Test, with a Bonferroni correction for alpha (p ≤ 0.016). RESULTS: In the group F the most affected areas were the jejunum (median histological score 25) and the duodenum (median histological score 22). The assessment of duodenum histological lesions depicted significant difference between F and B groups (U = 1.5, p = 0.007) and between F and C groups (U = 0, p = 0.003). Graded microscopic degenerative lesions on jejunum were significantly different between F and C groups (U = 0, p = 0.004). Graded TLR4 immunopositive cells in the jejunum surface epithelium was significantly different between groups F and C (U = 2.5, p = 0.006). In the colonic mucosa, significantly differences were noted on microscopic degenerative lesions between F and A groups (U = 0, p = 0.004) and between F and C groups (U = 0, p = 0.004). CONCLUSIONS: Pretreatment with 200 mg/kg of rifaximin for 3 consecutive days proved efficient in preventing intestinal mucosal degenerative lesions induced by 5-FU.

Effect of verapamil on purified bovine carbonic anhydrase. An in vitro study.

Relying on previous data which prove the activation of purified and gastric mucosa carbonic anhydrase by interaction of histamine with calcium ions, the present paper investigates the effect of verapamil, a specific antagonist of calcium transport, on purified bovine red cell carbonic anhydrase. In vitro determination of enzymatic activity according to Maren's micromethod showed that verapamil, in concentrations ranging from 10(-8)-10(-3) mol/l inhibits carbonic anhydrase basal activity in a dose-dependent manner. Thus, at 10(-3) mol/l verapamil concentration - representing its maximal effect - carbonic anhydrase basal activity drops from 2114 +/- 244 IU to 1100 +/- 86 IU (p less than 0.01). At this concentration, the drug antagonizes the activating effect of histamine: while maximum concentration (10(-2) mol/l) of histamine activates the enzyme from 2116 +/- 182 IU to 3979 +/- 411 IU the enzyme activity in the presence of verapamil changes in a non-significant way to 2162 +/- 148 IU (p less than 0.10). As calcium was omitted from the in vitro system, the mechanism described here is probably independent of ion transport inhibition. The physiologic importance of this effect for gastric secretion is to be further clarified.

"Ulcosilvanil"--an inhibitor of carbonic anhydrase--associated with adrenergic beta-blockers in the treatment of duodenal ulcers.

Knowing the in vivo inhibitory effect of the beta-adrenoreceptor antagonists on gastric mucosa carbonic anhydrase and the high clinical efficacy of "Ulcosilvanil" in the healing of gastric and duodenal ulcers, the authors combined propranolol with smaller doses of "Ulcosilvanil" in 925 active duodenal ulcer patients, divided into four groups. The first 236 patients were treated with small doses of "Ulcosilvanil" (20 mg/kg b.w./day active substance), the second group (of 258 cases) with high doses (35 mg/kg b.w./day) of "Ulcosilvanil", the third one (182 subjects) with propranolol only (60 mg/day) and the fourth group (349 patients) with small doses of "Ulcosilvanil" associated with 60 mg/day propranolol. Pain disappeared in all the cases of groups 1,2 and 4 after 3-6 days of treatment and in 40% of the third group. Basal acid output decreased, after 10 days of treatment, from 6.15 +/- 1.57 to 1.94 +/- 0.66 mEq/h in the first group (p less than 0.001), from 7.98 +/- 2.34 to 0.01 +/- 0.01 mEq/h in the second group (p less than 0.001), from 6.43 +/- 2.45 to 2.09 +/- 0.50 mEq/h in the third group (p less than 0.02) and from 6.76 +/- 2.80 to 0.011 +/- 0.01 mEq/h in the fourth group (p less than 0.001). Endoscopic healing was achieved, after 14 days of treatment, respectively in 78.5%, 92.4%, 51.6% and 88.41%; this percentages increased to 82.3%, 96.8%, 68.1% and 93.5% after 21 day of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)