Impact of reinforced education by telephone and short message service on the quality of bowel preparation: a randomized controlled study.

BACKGROUND AND STUDY AIMS: High quality bowel preparation is essential for successful colonoscopy. This study aimed to assess the impact of reinforced education by telephone or short message service (SMS) on the quality of bowel preparation. PATIENTS AND METHODS: A prospective, endoscopist-blinded, randomized, controlled study was conducted. Reinforced education groups received additional education via reminders by telephone or SMS 2 days before colonoscopy. The primary outcome was the quality of the bowel preparation according to the Boston Bowel Preparation Scale (BBPS). The secondary outcomes included polyp detection rate (PDR), adenoma detection rate (ADR), tolerance, and subjective feelings of patients. RESULTS: A total of 390 patients were included. Total BBPS score was significantly higher in the reinforced education groups than in the control group (mean [SD] telephone vs. CONTROL: 7.1 [1.2] vs. 6.3 [1.4], P < 0.001; SMS vs. CONTROL: 6.8 [1.3] vs. 6.3 [1.4], P = 0.027). Between the two interventions, there was no significant difference in total BBPS score. PDR and ADR were not different among groups. Reinforced education groups showed lower anxiety and better tolerance compared with controls. A preparation-to-colonoscopy time of > 6 hours and < 80 % of the purgative ingested were independent factors associated with inadequate bowel preparation (BBPS < 5), whereas re-education by telephone was inversely related to inadequate bowel preparation. CONCLUSION: SMS was the optimal education modality, and was as effective as telephone reminders for the quality of bowel preparation. A reinforced educational approach via telephone or SMS should be individualized, depending on the resource availability of each clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01911052).

Endoscopic treatments of gastric mucosal lesions are not riskier in patients with chronic renal failure or liver cirrhosis.

BACKGROUND: Little is known about the feasibility of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for patients with chronic renal failure (CRF) or liver cirrhosis (LC). This study aimed to assess the safety, efficacy, and clinical outcomes of EMR or ESD in patients with CRF or LC compared to those in patients without. METHODS: Between February 2003 and November 2009, a total of 1016 gastric neoplastic lesions in 928 patients were treated by using EMR or ESD. Among them, 18 patients had LC and 17 patients had CRF. Their medical records were reviewed retrospectively. En bloc resection rate, histological complete resection rate, operation time, and complications were compared between patients with CRF or LC and those without (control group). RESULTS: Baseline characteristics were not significantly different between the CRF, LC, and control groups except for a high rate of comorbidities in the CRF group and prolonged prothrombin time in the LC group. Operation time and therapeutic outcomes such as en bloc and complete resection rates did not differ significantly between the groups. Immediate bleeding tended to occur more frequently in the CRF+LC group than in controls (47.5 vs. 33.9%, p=0.077). There was no significant difference in the incidence of perforation between the CRF, LC, and control groups. The hospital stay was longer in the CRF+LC group than in the control group (6.4±3.53 vs. 4.9±3.15 days, p=0.012). CONCLUSIONS: EMR and ESD for the treatment of early gastric neoplasia may be equally effective and tolerable in the CRF or the LC group compared to the control group, although patients with CRF or LC might need the longer admission period than the control group.

A case of Sweet's syndrome in a patient with liver cirrhosis caused by chronic hepatitis B.

Sweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis, is characterized by the sudden onset of painful erythematous skin lesions together with fever and neutrophilia. SS can be associated with several disorders, such as malignancy, autoimmune disease, and infections. However, SS associated with liver cirrhosis is uncommon. We report a case of SS in a patient who was diagnosed with liver cirrhosis caused by chronic hepatitis B.

[Shifting in seroprevalence of HBsAg and anti-HCV during recent 10 years in adults resident in Daegu and Gyeongbuk province].

BACKGROUND/AIMS: There have been only few studies on the population-adjusted seroprevalence of HBV and HCV and on the change of them for more than 10 years in Korea. Therefore, this study was performed to evaluate them at a single health center in Daegu and Gyeongbuk province considering the population composition ratio. METHODS: We analyzed the seromarkers of HBV and HCV of 6,237 randomly sampled adults who had received health screening at the health promotion center in Dongsan hospital during the periods from year 1997 to 1999 (Period A) and from 2007 to 2009 (Period B). RESULTS: The seroprevalences of HBsAg, anti-HBs, anti-HBc and anti-HCV were 4.8%, 70.2%, 47.4%, and 0.5%, respectively. There is no difference in the seroprevalence of HBsAg between period A and B. However, downward tendency of prevalence through A to B from 6.8% to 4.5% could be found in 40s, and upward tendency from 4.7% to 6.8% in 50s. As for the seroprevalence of anti-HCV, although there was no difference through A to B, for 50s, it decreasd from 2.0% to 0.3% (p=0.007). However, for 60s, it increased as much as decreasd for 50s. CONCLUSIONS: The seroprevalence of HBsAg in Daegu/Gyeongbuk province was 4.8% and showed no difference through the time period of 10 years. The seroprevalence of anti-HCV was 0.5% and also showed no difference through the time periods.