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Biomedical subjects

Jack A DiPalma

Publications and source records attributed to Jack A DiPalma.

9 recordsLinked to original sources
PubMed2005

Do gastroenterologists notify polyp patients that family members should have screening?

OBJECTIVE: The objective of this study was to determine whether patients found to have adenomatous polyps or cancer were notified that their relatives should have screening, due to an increased risk of developing colorectal cancer. METHODS: Consecutive (n = 121) colonoscopy patients from December of 1999 to October of 2001 found to have adenomatous colon polyps or colon cancer formed the study group. Charts were reviewed for documentation of relative notification, and when documentation was not present, study subjects were contacted by telephone. RESULTS: Overall, 71% had data that were able to be evaluated; the remaining 29% were unable to be contacted because of changes of address or phone numbers. Adenomatous polyps were seen in 95%, and cancer seen in 5%. Overall, 30% of the patients were notified: 23 of 82 (28%) in the polyp group and 3 of 4 (75%) in the cancer group. Advanced adenomas or multiple adenomas were noted in 28 of the 82 (34%). Of those, 8 of 28 (29%) were notified. CONCLUSIONS: Gastroenterologists should be aware of the need for increased attention to family notification, especially in those with advanced adenomas or multiple adenomas. Template notification letters may complement the polyp surveillance programs that many colonoscopists use.

Adult↗
PubMed2005

U.S. practices for colon cancer screening.

As the prevalence of gastric carcinoma decreases in Japan, the prevalence of colon cancer has been increasing. Examination of the screening practices for colon cancer in the United States can offer insight into practices that may be useful in Japan. This paper will review the epidemiology and risk factors for colon cancer, the genetics of colon cancer, prevention issues, screening modalities, and current recommendations in U.S. practice.

Colonic Neoplasms↗
PubMed2004

Bowel preparation for gastrointestinal procedures.

Adequate colonic cleansing is essential for accurate and safe colonic procedures. Common preparations for cleansing include diet in combination with a cathartic agent, gut lavage, and phosphate preparations. The diet used with a cathartic consists of clear liquids or is designed to leave a minimal colonic fecal residue with laxatives. Gut lavage solutions wash out the colon in a safe and effective manner. Phosphate preparations offer an attractive alternative due to smaller volumes required for ingestion; however, electrolyte disturbances can occur. This review discusses the development and clinical experience with various colon cleansing regimens and efforts to improve the tolerability and safety of preparation for colonoscopy, virtual colonoscopy, colon surgery, barium enema, and flexible sigmoidoscopy.

Administration, Oral↗
PubMed2004

Brachial blood pressure monitoring versus ankle monitoring during colonoscopy.

OBJECTIVES: To compare ankle and brachial blood pressure monitoring before and during colonoscopy using automated noninvasive blood pressure (NIBP) monitors. METHODS: Forty-five consecutive patients who presented for outpatient colonoscopy had both ankle and brachial blood pressure monitoring with automated NIBP using an appropriately sized cuff for arm or leg size. Three baseline measurements were obtained, and then measurements were taken at 5-minute intervals during conscious sedation, with brachial blood pressure being the standard. RESULTS: The average of all of the ankle blood pressures was significantly higher for all systolic and mean arterial blood pressure readings. Diastolic blood pressure readings were higher at baseline, but not significantly different during the procedure. CONCLUSIONS: Ankle systolic and mean arterial blood pressures using automated NIBP monitoring for conscious sedation are significantly higher than brachial blood pressures. Ankle NIBP monitoring should only be used if brachial NIBP monitoring is not feasible, taking into consideration that ankle NIBP pressures are generally higher than brachial.

Adult↗
PubMed2004

Current treatment options for chronic constipation.

Various agents are used for the medical management of chronic constipation but few have been carefully studied. This review examines available data concerning several bulk and fiber products, lubricating agents, stimulants, and osmotic laxatives, alone and in combination. Popular therapeutic options for initial treatment of chronic constipation are dietary fiber and medicinal bulk. Subsequent treatments if fiber is not successful or tolerated would include saline osmotic laxatives, lactulose, or stimulants like senna or bisacodyl. Recent data demonstrate polyethylene glycol laxative to be safe and effective as an initial or second-line agent for chronic constipation. Indications and use of surgery and biofeedback are also discussed.

Biofeedback, Psychology↗
PubMed2003

Comparison of reduced volume versus four liters sulfate-free electrolyte lavage solutions for colonoscopy colon cleansing.

OBJECTIVE: In an attempt to improve patient tolerance for colonoscopy cleansing, a reduced volume lavage regimen with 2 L sulfate-free electrolyte lavage solution (SF-ELS, NuLYTELY, Braintree Laboratories, Braintree, MA) plus 20 mg p.o. bisacodyl (Half Lytely, Braintree Laboratories) was compared with standard 4 L SF-ELS lavage for safety and efficacy. METHODS: At two centers, 200 patients undergoing colonoscopy for routine indications were randomized to receive the reduced volume or standard 4 L method. The day before scheduled colonoscopy, study subjects were allowed a normal breakfast and clear liquids for lunch and dinner. Those randomized to receive the reduced volume method received four 5-mg bisacodyl tablets p.o. at noon. Six hours later, they received 2 L SF-ELS given as 10 oz every 10 min. Subjects randomized to receive 4 L SF-ELS also drank their solution at 6:00 PM in a similar fashion. Colonoscopists, unaware as to the randomized preparation received, rated efficacy of cleansing. Patient tolerance and various hematological and biochemical parameters were assessed. RESULTS: Physician assessment of colon cleansing showed no differences between those patients randomized to receive reduced volume (n = 93) or 4 L (n = 93) SF-ELS cleansing (p = 0.16). There was a profound reduction in preparation side effects. The reduced volume preparation had less fullness (p < 0.01), nausea (p < 0.01), vomiting (p = 0.01), and overall discomfort (p < 0.01). There were no clinically significant changes in hematology or blood chemistry associated with either preparation. CONCLUSIONS: Reduced volume preparation with 2 L SF-ELS and bisacodyl is safe and effective. Clinical symptoms from the reduced volume preparation are significantly reduced compared with traditional 4 L gut lavage.

Adult↗
PubMed2003

Abdominal pain associated with lactose ingestion in children with lactose intolerance.

The causal relationship between lactose ingestion and gastrointestinal symptoms is questionable. The aim of this study was to assess symptoms associated with milk ingestion in children with lactose maldigestion. Thirty children (11 males) age 3 to 17 years with lactose maldigestion were studied. In a double-blind, crossover design, subjects ingested 240 mL daily of either lactose-hydrolyzed or lactose-containing milk for 14 days. Diaries were kept daily that recorded diet, medication use, and symptoms. There was a significant increase in abdominal pain experienced by study participants during the lactose ingestion period when compared to the lactose-free period. We conclude that ingestion of 12 g of lactose daily is associated with increased abdominal pain in susceptible children with lactose maldigestion. A trial of dietary lactose restriction may be beneficial in reducing abdominal pain in children with lactose maldigestion.

Abdominal Pain↗
PubMedDate not supplied

Women's colonic digestive health.

Digestive problems in women are common and sometimes debilitating. Twenty percent of women suffer from irritable bowel syndrome, 20% have constipation, and all American women will need screening for colon cancer, the number two cause of cancer death in women. This article reviews management of these disorders as well as lower gastrointestinal symptoms associated with menses, hysterectomy, fecal incontinence, and rectal bleeding.

Colonic Diseases↗