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BACKGROUND AND AIM: It has been reported that oral phosphosoda (OPS), commonly used in bowel cleansing, may cause complications such as hyperphosphatemia and hypocalcemia. This has been observed in patients with normal kidney function and in those with renal insufficiency. Few controlled studies have been performed with respect to age on healthy subjects after OPS administration. METHODS: Seventy patients (38 men and 32 women; mean age 47 +/- 12 years, range 25-80 years) were enrolled in the present study. Half of the 90 mL total volume of OPS was ingested 18 h before colonoscopy, and the other half 6 h before the procedure. Creatinine clearance rate (CCR) and serum levels of sodium, potassium, calcium and phosphate were measured before and after OPS administration. RESULTS: After OPS administration, serum calcium and potassium were significantly lower (P < 0.05), and serum phosphate and sodium were significantly higher than pretreatment levels (P < or = 0.01). The statistically significant changes in serum sodium, potassium and calcium were within normal laboratory ranges. The mean change in serum phosphate was positively correlated with age (Pearson's r = 0.705; p < 0.001). CONCLUSION: Administration of OPS causes a significant rise in serum phosphate, even in patients with normal CCR. The elevation is significantly greater in elderly patients. Administration of OPS can be considered safe for young and middle-aged patients with normal renal function; however, it should be used with caution in elderly patients, even in those with normal CCR and serum creatinine values.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14675245&dopt=Abstract constipation laxative colon cleansing [PubMed - in process]

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BACKGROUND: Both sodium phosphate (NaP) and polyethylene glycol-electrolyte (PEG-EL) have been used to cleanse the bowel prior to colonoscopy, and recent reviews suggest that the former is the more effective and convenient cleansing regimen. The aim of this study was to compare the bowel cleansing effect of NaP solution with that of PEG-EL solution and to evaluate whether the cleansing effect correlates with the time needed to perform colonoscopy. METHODS: 111 patients admitted for colonoscopy were randomized to receive either 90 mL oral NaP or 4 litres of PEG-EL solution. Cleansing was scored blindly by one colonoscopist and the following times were recorded: caecal intubation, withdrawal and total colonoscopy. RESULTS: Of all the patients included in the study, 99 were evaluable. The mean and standard error of the mean (+/-S(chi)-) cleansing score was 3.64 +/- 0.16 in the NaP group and 2.69 +/- 0.9 in the PEG-EL group (P = 0.005). The mean (+/-S(chi)-) caecal intubation times were 6.39 +/- 0.50 min and 5.39 +/- 0.41 min (P = 0.13), the withdrawal times 4.26 +/- 0.20 min and 5.78 +/- 0.34 min (P = 0.0001) and the total colonoscopy times 10.65 +/- 0.52 min and 11.17 +/- 0.56 min (P = 0.50) in the NaP and PEG-EL groups, respectively. The subgroup of patients with a cleansing score of 3 or more was associated with shortened colonoscopy withdrawal time compared to the group scoring below 3. CONCLUSIONS: Better cleansing of the large bowel shortens colonoscopy withdrawal time. Sodium phosphate is a more effective bowel-cleansing regimen than polyethylene glycol, and the better cleansing result is associated with shortened colonoscopy withdrawal time.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14686724&dopt=Abstract constipation laxative colon cleansing [PubMed - in process]




Eur Radiol. 2004 Feb 13 [Epub ahead of print]
MR-based full-body preventative cardiovascular and tumor imaging: technique and preliminary experience.

Goyen M, Goehde SC, Herborn CU, Hunold P, Vogt FM, Gizewski ER, Lauenstein TC, Ajaj W, Forsting M, Debatin JF, Ruehm SG.

Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Recent improvements in hardware and software, lack of side effects, as well as diagnostic accuracy make magnetic resonance imaging a natural candidate for preventative imaging. Thus, the purpose of the study was to evaluate the feasibility of a comprehensive 60-min MR-based screening examination in healthy volunteers and a limited number of patients with known target disease. In ten healthy volunteers (7 men, 3 women; mean age, 32.4 years) and five patients (4 men, 1 woman; mean age, 56.2 years) with proven target disease we evaluated the performance of a comprehensive MR screening strategy by combining well-established organ-based MR examination components encompassing the brain, the arterial system, the heart, the lungs, and the colon. All ten volunteers and five patients tolerated the comprehensive MR examination well. The mean in-room time was 63 min. In one volunteer, insufficient colonic cleansing on the part of the volunteer diminished the diagnostic reliability of MR colonography. All remaining components of the comprehensive MR examination were considered diagnostic in all volunteers and patients. In the five patients, the examination revealed the known pathologies [aneurysm of the anterior communicating artery ( n=1), renal artery stenosis ( n=1), myocardial infarct ( n=1), and colonic polyp ( n=2)]. The outlined MR screening strategy encompassing the brain, the arterial system, the heart, the lung, and the colon is feasible. Further studies have to show that MR-based screening programs are cost-effective in terms of the life-years saved.

Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14968262&dopt=Abstract constipation laxative colon cleansing [PubMed - as supplied by publisher]


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