Study on the effectiveness of modified colonoscopy nursing pads in colonoscopy.

OBJECTIVE: To investigate the effect of modified colonoscopy nursing pads in colonoscopy. METHODS: A total of 262 subjects who underwent colonoscopy at our endoscopy center between September 1, 2021 and February 28, 2022 were selected and randomly divided into a control group and an experimental group, with 131 cases in each group. The control group used conventional nursing pads, while the experimental group used modified nursing pads. The success rate of the first correct position, the time spent by the nurse to guide the correct position, the bed unit contamination rate, the contamination rate of the operator's protective equipment, the privacy protection of the examinees and the satisfaction degree after the examination were compared between the two groups. RESULTS: The success rate of the first correct position of the examinees in the experimental group was significantly higher than that of the control group (P < 0.05), and the time spent by the nurses to guide the correct position in the experimental group was less than that of the control group (P < 0.05). The bed unit contamination rate and operator's protective equipment contamination rate of the experimental group were lower than those of the control group, and the satisfaction degree of the examinees was higher in the experimental group than in the control group, and the differences were statistically significant (P < 0.05). CONCLUSION: The modified colonoscopy nursing pad can save the time of correct colonoscopy positioning of examinees, improve the efficiency of colonoscopy, reduce the workload of nursing staff, effectively protect the privacy of patients, reduce the bed unit contamination and protective equipment contamination, and then improve the comfort and satisfaction of patients.

Face-to-Face Instruction and Personalized Regimens Improve the Quality of Inpatient Bowel Preparation for Colonoscopy.

BACKGROUND: Poor bowel preparation is commonly observed in inpatients undergoing colonoscopy, particularly those with higher risks for inadequate bowel preparation. AIMS: The objective of this study was to determine whether personalized bowel preparation regimens combined with face-to-face instruction (FFI) could improve the quality of bowel preparation for inpatient. METHODS: In this endoscopist-blinded, randomized controlled trial, 320 inpatients were enrolled and randomly allocated (1:1) to the control and intervention groups. The intervention group received FFI and personalized bowel preparation regimens, while the control group received the routine bowel preparation regimen and education. The primary outcome was adequate bowel preparation rate. Secondary outcomes included rates of procedure-related adverse events, incorrect diet restriction and laxative intake, etc. RESULTS: The adequate bowel preparation rate in the intervention group was significantly higher compared to control group [intention-to-treat (ITT) analysis: 70.0% vs 51.3%, P < 0.001; per-protocol (PP) analysis: 79.4% vs 58.6%, P < 0.001]. Bowel cleanliness was significantly improved in high-risk inpatients (ITT analysis: 65% vs 44.6%, P = 0.004; PP analysis: 73.0% vs 51.7%, P = 0.004) and in low-risk inpatients (ITT analysis: 80% vs 62.7%, P = 0.037; PP analysis: 92.3% vs 69.8%, P = 0.003). There were no significant differences between two groups regarding procedure-related adverse events. CONCLUSIONS: Personalized bowel preparation regimens combined with FFI improve the rate of adequate bowel preparation, especially for patients with high-risk factors. As such, inpatients could benefit from this novel approach for better bowel preparation to ultimately improve the quality of colonoscopies.

Colorectal stent placement assisted by a slim gastroscope: technique and outcomes.

BACKGROUND: The distorted anatomy in patients with obstruction renders colon stent placement difficult. Here, we propose two novel techniques for stent implantation. METHODS: Patients in whom there was difficulty placing the guidewire with the normal method were retrospectively included in our study. All of the patients underwent the technique of combining a slim gastroscope with a normal colonoscope. We assessed the technical success, clinical success, and adverse events associated with self-expanding metal stent placement. RESULTS: From June 2018 to June 2020, 30.5% of patients with difficult catheterization were included in this study. Finally, stents in 17 of 18 patients (3 rectum, 13 sigmoid colon, 1 descending colon, and 1 hepatic flexure) (94.4%) were placed successfully, assisted by a slim gastroscope with or without radiography, and the obstruction was relieved. Only one remaining patient experienced failure. No intraoperative or 30-day postoperative morbidity or mortality was observed. CONCLUSION: The present study showed that the stent implantation technique assisted by a slim gastroscope combined with a normal colonoscope was a relatively safe and effective method for abolishing difficult intestinal stenosis. More studies are needed to compare the advantages and disadvantages of this technique with normal endoscopic implantation.

Impact of a Telephone Intervention on Bowel Preparation Quality for Colonoscopy in the Elderly.

Bowel preparation is the basis of colonoscopy, and adequate bowel preparation is essential to the success of colonoscopy. Studies have been reported that telephone intervention can improve the quality of bowel preparation, while it remains unclear regarding effectiveness with the elderly. The purpose of this study was to evaluate the effect of telephone intervention on the quality of bowel preparation for colonoscopy in elderly outpatients. In total, 162 outpatients older than 65 years were enrolled and randomly divided into a control group and a study group. Patients in the study group were re-educated through telephone by a specific nurse 2 days before colonoscopy, whereas participants in the control group received education only on the day of appointment. The Ottawa score was used to evaluate the quality of bowel preparation between the two groups. In this study, no significant differences were observed in age, gender, body mass index, educational level, smoking and/or alcohol drinking, waiting time to colonoscopy, reasons for colonoscopy, and colonoscopic findings between the control group and the study group. Participants in the study group had higher adequate bowel preparation and compliance than the control group (83.1% vs. 59.5%, p = .03; 96.4% vs. 74.7%, p < .001). Univariate analysis showed that only noncompliance with start time was significantly associated with satisfactory bowel preparation in elderly patients. In conclusion, telephone intervention 2 days before colonoscopy can improve the quality of bowel preparation in the elderly.

Differences with experienced nurse assistance during colonoscopy in detecting polyp and adenoma: a randomized clinical trial.

OBJECTIVES: This study aims to evaluate whether the participation of an experienced endoscopy nurse in colonoscopy increases the polyp detection rate (PDR) and adenoma detection rate (ADR) of experienced colonoscopists. METHODS: This study was a randomized controlled trial. Patients were randomly assigned to the experienced colonoscopist alone (single observer) group, or experienced nurse participation (dual observer) group. The primary outcome was the PDR and ADR. The advanced lesion detection rate was also recorded. RESULTS: A total of 587 patients were included in the analysis. Among these patients, 291 patients were assigned to the single observer group, while 296 patients were assigned to the dual observer group. The PDR was 33% in the single observer group and 41.9% in the dual observer group (P = 0.026), while the ADR was 23.0% in the single observer group and 30.4% in the dual observer group (P = 0.043). No significant difference was found for advanced lesions between groups. CONCLUSIONS: The present data demonstrated that experienced nurse observation during colonoscopy can improve polyp and adenoma detection rates, even if the colonoscopist is experienced. TRIAL REGISTRATION: Clinicaltrials.gov No. NCT02292563. https://clinicaltrials.gov/ct2/results?cond=&term=NCT02292563&cntry=&state=&city=&dist=.

Gelatin-Functionalized Carbon Nanotubes Loaded with Cisplatin for Anti-Cancer Therapy.

Cisplatin (Cp), a chemotherapeutic agent, interacts with purines on tumor DNA, causing tumor cell apoptosis. However, cisplatin has the characteristics of non-specific distribution and lack of selectivity, resulting in systemic toxicity. Moreover, it cannot maintain the drug's high concentration in the tumor-weak acid environment. These flaws of cisplatin restrict its use in clinical applications. Therefore, a pH-responsive carbon nanotube-modified nano-drug delivery system (CNTs/Gel/Cp) was constructed in this study using gelatin (Gel)-modified carbon nanotubes (CNTs/Gel) loaded with cisplatin to release drugs precisely and slowly, preventing premature inactivation and maintaining an effective concentration. When MCp:MCNTs/Gel = 1:1, the drug reaches the highest loading rate and entrapment efficiency. To achieve the sustained-release effect, CNTs/Gel/Cp can release the medicine steadily for a long time in a pH environment of 6.0. Additionally, CNTs/Gel/Cp display antitumor properties comparable to cisplatin in a manner that varies with the dosage administered. These findings indicate that CNTs/Gel/Cp have an effective, sustained release of cisplatin and a good antitumor effect, providing a theoretical and experimental basis for the clinical application of modified carbon nanotubes (CNTs) as a new drug delivery system.

The efficacy and tolerability of sports drink versus water in bowel preparations: a randomised controlled study.

BACKGROUND: An optimal bowel preparation can result in an improved colonoscopy. This study was to compare the effectiveness and safety of the use of a sports drink (Mizone) plus polyethylene glycol (PEG) solution with a water plus PEG solution in bowel preparations. METHODS: This was a randomised controlled study. All of the included patients were randomly divided into the following two groups: the PEG + Mizone group and the PEG + water group. The palatability of the solution was measured through the use of questionnaires. Additionally, bowel cleanliness was evaluated according to the Ottawa Bowel Preparation Scale (OBPS, 0-14, with higher values indicating worse cleanliness), as well as with the aid of colonoscopy videos. RESULTS: A total of 270 patients were enrolled. The rate of adequate bowel preparation was 74.8% in the PEG + Mizone group and 68.9% in the PEG + water group, with a risk difference of 5.9% (95% CI: - 4.8-16.6%), which indicated noninferiority (noninferiority margin: - 9.5% < - 4.8%). However, patients rated the palatability (65.9% vs 44.4%, P < 0.001) and willingness to recommend or repeat (88.9% vs 75.6%, P = 0.004) the administration of the PEG + Mizone preparation as being better than those of the PEG + water preparation. The rates of adverse events during the bowel preparations were not significantly different between the two groups, except for bloating (PEG + Mizone vs PEG + water, 4.4% vs 13.3%, P = 0.010). CONCLUSION: The concomitant use of PEG + Mizone was a well tolerated and effective bowel preparation, compared with the PEG + water treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04247386 . Registered on 30 Jan 2020.