Dose Of Polyethylene Glycol Research Articles

Evaluation of Polyethylene Glycol Dosing for Functional Constipation in Children.

Objective: The goal of this study was to evaluate the current use of polyethylene glycol (PEG) in a pediatric gastroenterology outpatient clinic. The primary endpoint was to determine the current weight-based PEG dosing schedules used for home cleanouts and maintenance treatment for functional constipation. The secondary endpoint was to assess the dosing efficacy for home cleanouts. Methods: This study was a retrospective cohort analysis of electronic medical records documenting new patient visits at our pediatric gastroenterology clinic between September 2017 and October 2018. Patients included in the study were 13 months to 18 years of age and prescribed PEG for an at-home cleanout and/or maintenance therapy for functional or slow transit constipation. Study participants given a clean-out regimen were divided into those who received treatment for less than 2 days or more. Cleanouts were considered successful if documented as such by the prescriber in the follow-up note or if there was documentation of clear flow. Results: Of the 201 new patients included, 112 (55.7%) received a recommendation for a home cleanout. Of these, 111 patients (99%) underwent PEG-based therapy with or without additional agents. The median weight-based PEG dose was 5.3 ± 2.4 and 4.6 ± 1.9 g/kg/day for 1- and 2-day cleanouts, respectively (P = 0.124). Of the 38 patients with documented outcomes, 28 (73.7%) were successful. We observed no statistically significant differences in the number of successful versus unsuccessful outcomes based on PEG dosing (P = 0.3) or cumulative dose exposures (P = 0.388). Similarly, we observed no significant differences when comparing those on 1-day versus 2-or-more-day cleanouts, (P = 0.17). The median weight-based maintenance PEG dose was 0.74 g/kg/day (interquartile range [IQR], 0.55, 0.96). Conclusions: While the PEG doses used by this clinic for 1-day bowel cleanouts align with the NASPGHAN best practices for colonoscopy report, patients who underwent a 2-day cleanout were provided more than double the weight-based doses. The doses were nearly 3-fold higher than the recommended doses for functional constipation home cleanouts. More information will be needed to determine if these higher doses for home cleanouts are needed for the successful management of patients with functional constipation.

Enhanced Antioxidant Activity and Secondary Metabolite Production in Tartary Buckwheat under Polyethylene Glycol (PEG)-Induced Drought Stress during Germination

Drought stress is one of the key factors impeding agricultural productivity worldwide. This experiment aimed at investigating the polyethylene glycol (PEG)-induced drought stress effects on seed germination, physiology, and biochemical mechanisms in Tartary buckwheat genotypes. Four PEG-induced stress conditions (0%, 10%, 20%, and 30%) were applied to 14 selected genotypes at the germination stage to evaluate their stress tolerance capacity. Significant differences were obtained in germination percentage, relative water content (RWC), and all growth parameters among the studied 14 genotypes. Based on the stress tolerance index (STI), XiNong 9943, XiNong 9940, and QianKu-5 were found to be tolerant, and QuanKu-4 was susceptible. These cultivars were selected for further physiological and biochemical characterization. The results demonstrated that the activity of enzymes was significantly increased with the increase in PEG dose. SOD (superoxide dismutase), POD (peroxidase), CAT (catalase), and APX (ascorbate peroxidase) levels obtained at 30% PEG in the XiNong 9943 genotype were 2.01, 2.19, 4.92, and 4.46 times higher, respectively, than the normal growth condition (T0). Moreover, the secondary metabolite content also increased with the increase in PEG dose. At 30% PEG, the genotype XiNong 9943 yielded phenols, flavonoids, polyphenol oxidase (PPO), and phenylalanine ammonia lyase (PAL) levels that were higher by 131%, 95%, 154%, and 164%, respectively, than T0 condition. From both the findings of the activity of enzymes and the secondary metabolite content, the genotypic response to drought was ranked in the following order: XiNong 9943 > XiNong 9940 > QianKu-5 > QianKu-4, which supported the STI selection system. Assessing the overall performance, the genotype XiNong 9943 shows drought tolerance, which can be useful material for future buckwheat breeding programs.

Presentation, characteristics and management of obstructive intestinal conditions in cystic fibrosis

ObjectiveConstipation and distal intestinal obstruction syndrome (DIOS) are common gastrointestinal manifestations of cystic fibrosis (CF). The primary aim was to describe the characteristics of constipation and DIOS hospitalisations in a...

SPLIT-DOSE BOWEL PREPARATION IS SUPERIOR TO STRAIGHT-DOSE IN HOSPITALIZED PATIENTS UNDERGOING INPATIENT COLONOSCOPY.

There is a two-fold higher rate of failed colonoscopy secondary to inadequate bowel preparation among hospitalized versus ambulatory patients. Split-dose bowel preparation is widely used in the outpatient setting but has not been generally adapted for use among the inpatient population. The aim of this study is to evaluate the effectiveness of split versus single dose polyethylene glycol bowel (PEG) preparation for inpatient colonoscopies and determine additional procedural and patient characteristics that drive inpatient colonoscopy quality. A retrospective cohort study was performed on 189 patients who underwent inpatient colonoscopy and received 4 liters PEG as either split- or straight-dose during a 6-month period in 2017 at an academic medical center. Bowel preparation quality was assessed using Boston Bowel Preparation Score (BBPS), Aronchick Score, and reported adequacy of preparation. Bowel preparation was reported as adequate in 89% of the split-dose group versus 66% in the straight-dose group (P=0.0003). Inadequate bowel preparations were documented in 34.2% of the single-dose group and 10.7% of the split-dose group (P<0.001). Only 40% of patients received split-dose PEG. Mean BBPS was significantly lower in the straight-dose group (Total: 6.32 vs 7.73, P<0.001). Split-dose bowel preparation is superior to straight-dose preparation across reportable quality metrics for non-screening colonoscopies and was readily performed in the inpatient setting. Interventions should be targeted at shifting the culture of gastroenterologist prescribing practices towards use of split-dose bowel preparation for inpatient colonoscopy.

Comparison of Same Day Polyethylene Glycol Regimen Vs Split Dose Polyethylene Glycol Regimen for Colonoscopy

Colonoscopy is a procedure which depends upon the quality of bowel preparation. Polyethylene glycol(PEG) is commonly used laxative for bowel preparation .The method of PEG administration affects the quality of bowel preparation. We designed this single-blinded randomized controlled trial to evaluate same day PEG regime vs split dose PEG regime in patients undergoing colonoscopy. METHOD: Total of 156 patients taken for the examination. They were divided randomly in two groups A &amp; B. The patients in the group A (same day group) took 2 L of PEG between 6:00 AM and 8:00 AM on the same day of colonoscopy. The patients in the other group B ( split dose group ) took 1L of PEG between 6:00 PM and 8:00 PM on the preceding day and another liter between 6:00 AM and 8:00 AM on the day of colonoscopy. These patients had to stay in hospital for about 24 hours.The accuracy of preparation was assessed on Boston Bowel Preparation Scale (BBPS). A sum total of ≤ 5 points shows poor bowel preparation &amp; ≥ 8 shows very good bowel preparation. Side effects were recorded by asking symptoms of nausea ,vomiting ,abdominal pain &amp; bloating. Results: In same day dose group, 62 patients were having BPPS preparation score of &gt;8 . While in second split dose group 64 patients were having BPPS preparation score &gt;8. Chi square test revealed that there was no significant difference in BPPS score between both groups. However there was significant difference in patient satisfaction and willingness to repeat the same procedure between both groups. . Group A same dose regime were more satisfied &amp; willing to repeat the procedure. They reported less interference in their sleep . Conclusion: Same- day morning PEG regime should be used which is more easy &amp; tolerable for our patients population and its efficacy is same as other regimes for adequate bowel preparation.

Effect and Mechanism of Polyethylene Glycol (PEG) Used as a Phase Change Composite on Cement Paste.

The use of phase change materials (PCMs) in the construction industry is one of the primary strategies for addressing the building industry’s present excessive energy usage. However, since PCMs must be enclosed before being used in construction, their efficiency is limited and their compatibility with concrete is poor. Thus, polyethylene glycol (PEG), a sequence of PCMs that may be put directly into concrete, is the target of this research. The fluidity, mechanical properties, thermal properties, hydration process, and hydration products of PEG-600 cement slurry were examined by TAM, XRD, FTIR, DSC, MALDI, etc., methods in this study. Furthermore, we tested the thermal properties of PEG-800 to confirm that the same depolymerization of PEG occurred in an alkaline environment. When PEG, with a molecular weight of 600 (PEG-600), dose was increased to 10%, both compressive and flexural strength fell by 19% and 18%, respectively. The phase change points of both PEG-600 cement paste and PEG-800 cement paste decreased to 10~15 °C, and the enthalpy of the phase change was about 6 J/g. Additionally, it was discovered that PEG entered the reaction during the hydration step. PEG underwent depolymerization and subsequently formed a complex with Ca2+. However, due to the large dose of PEG used in this investigation, a self-curing effect of PEG in concrete was not seen. The findings of this research suggest a novel use for PCMs: PEG may be directly applied to concrete to fulfill both mechanical and thermal requirements. Additionally, the number of hydration products and phase compositions remained almost constant.

Safety of COVID-19 vaccination in patients with polyethylene glycol allergy: A case series

Safety of COVID-19 vaccination in patients with polyethylene glycol allergy: A case series

Efficacy of macrogol 4000 plus electrolytes in bowel preparation for colonoscopy in patients with chronic constipation

BackgroundChronic constipation is a significant factor in poor bowel preparation for colonoscopy. Macrogol 4000 plus electrolytes (Movicol, EA Pharma, Tokyo, Japan), containing polyethylene glycol (PEG) and electrolytes, have been used recently to treat patients with constipation. However, prospective studies on the use of macrogol 4000 for bowel cleansing for colonoscopy are lacking. This study aimed to investigate the efficacy and safety of macrogol 4000 in addition to PEG administered in patients with chronic constipation.MethodsThis single-center, single-arm prospective study enrolled patients with chronic constipation who were scheduled to undergo colonoscopy. The primary endpoint was the proportion of good bowel preparation assessed using the Boston bowel preparation scale (BBPS) (6 or more points). The secondary endpoints were the time from when pPEG (MoviPrep, EA Pharma, Tokyo, Japan) was taken until colonoscopy could be started, amount of PEG taken, number of defecations, whether additional PEG doses were taken, and adverse events. Endoscopy-related endpoints included cecal intubation rate, insertion time, observation time, adenoma detection rate (ADR), and polyp detection rate (PDR). The tolerability of PEG and macrogol 4000 was assessed using a questionnaire.ResultsForty patients were included in the analysis. The median BBPS was 7 (range 3–9) and ≥ 6 points in 37 cases (92.5%). The median time until colonoscopy can be started was 210 min (90–360 min), the median volume of PEG taken was 1500 mL (1000–2000 mL), and the median number of defecations was 7 (3–20). No adverse events were observed. Fourteen patients required an additional dose of PEG. Cecal intubation was achieved in all cases, the median insertion time was 6.0 min (range 2.3–22 min), and the median observation time was 8.8 min (range 4.0–16.0 min). The ADR and PDR were 60.0% and 75.0%, respectively. A proportion of patients rated the tolerability of macrogol 4000 and PEG as 95.0% and 50.0%, respectively.ConclusionsIntake of macrogol 4000 in addition to PEG is effective and safe for colonoscopy in patients with chronic constipation.Clinical trial registration statement This study was registered in the UMIN-CTR database (UMIN-ID000038315).

The magnitude and management of functional constipation at pediatric gastroenterology clinics: A survey study of various countries.

There have been no large-scale epidemiological study of functional constipation of pediatric gastroenterology services. This survey was undertaken to investigate the prevalence of functional constipation and magnitude of related problems in hospital settings of various countries as well as the practice of pediatric gastroenterologists in management of these conditions. The survey was conducted by sending questionnaires to members of Societies for Pediatric Gastroenterology Hepatology and Nutrition of various continents. A total of 274 pediatric gastroenterologists from 41 countries participated in this study. Functional constipation accounted for overall 30% of patients attending pediatric gastroenterology outpatient clinics. In comparison with non-western countries, respondents from western countries reported significantly higher median annual numbers of new patients with intractable functional constipation (10 [4,25] vs 5 [2,10], P < 0.001), dyssynergic defecation (3 [0,15] vs 1 [0,4], P < 0.001), and colonic inertia (2 [0,5] vs 0 [0,1], P < 0.001). The use of high dose polyethylene glycol for fecal disimpaction was significantly more commonly among respondents from western countries, whereas rectal enema was significantly more favored in non-western countries. Respondents from different continents reported significant discrepancies in choices of investigations and management of patients with dyssynergic defecation and colonic inertia. Functional constipation is a major problem for pediatric gastroenterology outpatient services worldwide. There were significant variations in the investigations of choice and therapeutic management of functional constipation, intractable functional constipation, and related problems among pediatric gastroenterologists of different geographic regions.

Effect of PEG on structure and physical properties of PVA/CMC nanofiber

Nanofibers are a new class of material with unique features and a wide scope of uses. This research article studies the preparation of a novel polymer nanofiber composite from polyvinyl alcohol (PVA) (10%) blended with carboxymethyl cellulose (CMC) (2.5%) with different doses of Poly Ethylene Glycol (PEG) (0.25, 0.5, 0.75 g). Four different samples of PEG0, PEG1, PEG2 and PEG3 were prepared (6.25,7.5, 8.75 and 10 total % (w/v) respectively and The morphology and the average diameter of the electro spun fibers were observed using Scanning-electron microscopy (SEM). The SEM analysis was used also to help in optimizing the PEG concentration and the electrospinning condition (needle-to-collector distance, voltage, and flow rate), that can be used for the preparation of nanofiber membrane composed of PVA/CMC/PEG. The results showed that the nanofiber morphology and diameters of the nanofibers (PEG1, PEG2 and PEG3) were enhanced and the beads disappeared with increasing the PEG concentration and the optimum values for the electrospinning parameters to obtain PEG3 nanofibers with less average diameter are flow rate of 1ml/h, Voltage of 25 kV and Needle-to-collector distance of 25 cm with average diameter of electro spun nanofibers 362 nm. Also the thermal stability of the PVA/CMC/PEG (PEG3) nanofiber membrane was investigated by TGA. The results explained that the sample lost about 7 % at 115 C in the first stage, and lost 93 % after reaching 550 C as second stage of polymer degradation. The water contact angle (WCA) for PEG3 was measured to assess the water absorption and swelling properties of the membrane and the results showed the WCA was 45.35. This value was evidence that the membrane had hydrophilic properties. Treatment with cross linking is necessary if it will use in waste water applications.

A134 A MULTI-CENTRE RANDOMIZED CONTROLLED TRIAL TO COMPARE TWO BOWEL CLEANSING REGIMENS AFTER A COLONOSCOPY WITH INADEQUATE BOWEL PREPARATION

Abstract Aims Failed bowel preparation is common during colonoscopy, yet the optimal purgative regimen to use for the next attempt is unknown. The objective of this study was to compare the efficacy, tolerability, and safety of two regimens at supratherapeutic doses for use after failed bowel preparation. Methods A multi-centre phase III endoscopist blinded randomized controlled trial (NCT02976805) was conducted in patients who failed bowel preparation, using the US Multi-Society Task Force (USMSTF) definition of inability to exclude polyps &amp;gt;5 mm in size and requiring a shortened interval to next colonoscopy. Regimen A consisted of 15 mg of bisacodyl and 2 + 2 L of split dose polyethylene glycol electrolyte solution (PEG) and Regimen B consisted of 15 mg of bisacodyl and 4 + 2 L of split dose PEG. The primary outcome was adequate bowel preparation, defined as a Boston Bowel Preparation Scale (BBPS) total score ≥ 6 with all segment scores ≥ 2. Secondary outcomes were adequate bowel preparation using the USMSTF definition, median BBPS, adenoma detection (ADR), advanced adenoma detection (aADR), sessile serrated polyp detection (SSPDR), and cecal intubation (CIR). Adverse events were assessed at the time of the colonoscopy and 14 days later. Results Between February 2017 and December 2019, 250 subjects were screened at four academic centres in Canada, of which 195 were randomized: 96 to Regimen A and 99 to Regimen B. The mean (SD) age was 60.6 (11.4) years, 87 (45.1%) were female, and the median (IQR) total BBPS score at previous failed colonoscopy was 3 (1,4). Regimen B was not superior to Regimen A in achieving adequate bowel preparation using the BBPS definition (87.6% vs. 91.1%, p=0.45) or the USMSTF definition (85.4% vs 91.1%, p=0.24), nor was it superior with respect to the median BBPS score (7 vs 7, p=0.50), mean ADR (31.5% vs 37.8%, p=0.37), aADR (11.2% vs 18.9%, p=0.15), SSPDR (5.6% vs 8.9%, p=0.40) or CIR (92.1% vs 96.7%, p=0.19). Regimen A had a higher adherence rate (88.2% vs. 74.7%, p=0.02) and greater willingness to undergo the bowel preparation again (91.2% vs. 66.2%, p&amp;lt;0.001). The only serious adverse event occurred in a patient randomized to Regimen B who was admitted to hospital for vomiting after colonoscopy. Conclusions Split dose 4L PEG with 15mg of bisacodyl is highly efficacious, well tolerated, and can be used for patients who previously failed first line bowel preparations. The additional 2L of PEG in Regimen B did not improve bowel preparation and was not as well tolerated. Funding Agencies AMOSO Opportunities Grant, Pharmascence Inc.

Effects of salt and PEG-induced drought stress on seedling performance of perennial ryegrasses (Lolium perenne L.) cultivars

Amaç: Bu çalışma, Lolium perenne çeşitlerinin fide gelişim aşamalarında tuz ve kuraklık stresine tepkisini belirlemek amacıyla yapılmıştır.Yöntem ve Bulgular: Tohum materyali olarak dört çok yıllık çim çeşidi (Apple GL, Ecologic, Barminton ve Solstice II) kullanılmıştır. Lolium perenne çeşitlerinde fide gelişim aşamalarında tuz (0, 50, 100, 150 ve 200 mM NaCl) ve kuraklık (0, -0.4, -0.8, -1.2. ve -1.6 MPa, PEG-6000) stresi oluşturmak için beş farklı dozda sodyum klorür ve polietilen glikol kullanılmıştır. Fide gelişimi denemeleri tesadüf parselleri deneme deseninde faktöriyel düzende 4 tekrarlamalı olarak yürütülmüştür. Lolium Perenne çeşitlerinin fide gelişimi, tuz ve kuraklık stresine toleransları araştırılmıştır. Araştırma sonucunda tuz uygulamasında fide kök uzunluğu hariç tüm özelliklerde çeşit, tuz stresi ve çeşit x tuz stresi interaksiyonların önemli olduğu belirlenmiştir. Kuraklık uygulamasında fide kök uzunluğu ve fide sap uzunluğu hariç tüm özelliklerde çeşit x PEG interaksiyonların önemli olduğu belirlenmiştir. Genellikle tuz ve kuraklık stresi arttıkça incelenen özelliklerde önemli azalma olduğu ortaya konmuştur.Genel Yorum: Lolium perenne çeşitlerinin fide gelişimi incelenen özelliklere göre, farklı oranda tepkiler vermiştir. Tuz’un ve PEG-6000'in Lolium perenne fide gelişiminde kuraklık stresi yaratmada yararlı bir ajan olduğu sonucuna varılabilir, ancak Lolium perenne tuz ve kuraklık stres toleransını daha iyi belirlemek için (150 mM )tuz ve (-1.2 MPa)'dan daha düşük ozmotik potansiyeller uygulanmalıdır. Çalışmanın Önemi ve Etkisi: Küresel ısınmanın etkilerini giderek hissedildiği günümüzde kuraklık sorunu ve alternatif su kaynaklarının kullanımına toleranslı tür ve çeşitlerin belirlenmesi çok önemli olacaktır. Kuraklık ve tuzluluk problemine toleranslı tür ve çeşitlerin kısa dönemde belirlenmesi de ayrıca önem taşımaktadır. 21 gün gibi kısa bir çalışma süreci ile yeşil alanlarda kullanılabilecek çeşitlerin test edilmesi tuzluluğa veya kurağa dayanıklı ya da toleranslı çeşidin belirlenmesi çim alanların sürdürülebilirliği açısından önem arz etmektedir.

Single versus split dose polyethylene glycol for bowel preparation in children undergoing colonoscopy: a systematic review and meta-analysis.

Polyethylene glycol (PEG) has been widely used for bowel preparation. However, the efficacy and safety of single and split dose PEG for bowel preparation in children undergoing colonoscopy remain unclear, it is necessary to evaluate the role of single and split dose PEG for bowel preparation in children population. PubMed et al. databases up to September 1, 2019 were systematically searched. Randomized controlled trials (RCTs) single and split dose PEG for bowel preparation in children undergoing colonoscopy were included. Based on the heterogeneity, data were synthesized using random-effects or fixed-effects models. Results were expressed as Mantel-Haenszel style odds ratio (OR) or mean difference (MD) with 95% confidence interval (95% CI). Four RCTs with 249 children were included. There was no significantly difference in the efficacy of single and split dose PEG for bowel preparation (OR =0.36, 95% CI: -0.12 to 1.10). The acceptability of split dose PEG for bowel preparation was significantly higher than that of single dose (OR =0.50, 95% CI: 0.29 to 0.85); the incidence of nausea in split dose PEG for bowel preparation was significantly lower than that of single dose (OR =2.1, 95% CI: 1.29 to 3.42); there was no significant difference on the incidence of abdominal pain between two regimes (OR =1.39, 95% CI: 0.67 to 2.89). Split dose PEG seems to be more superior to single dose for children undergoing colonoscopy. However, considering that the number of included RCTs are very limited, more related studies on this issue are needed in the future.

Polyethylene Glycol Dosing for Constipation in Children Younger Than 24 Months: A Systematic Review.

Evaluate safety and effectiveness of Polyethylene glycol (PEG) for chronic constipation in children aged younger than 24 months. Identify the optimum dose of PEG to manage chronic constipation in children aged younger than 24 months. In this systematic review, Embase, Medline Ovid, Pubmed, and the Cochrane Library were searched between January 1, 2000 and February 1, 2019. Studies investigating functional constipation, in which patients younger than 24 months of age were treated with PEG, were considered as potentially eligible for review. Two authors screened the studies against inclusion/exclusion criteria. Study quality was assessed with the PEDro quality assessment, Cochrane risk of bias tool, and/or the Newcastle-Ottawa Scale. Five studies (2 randomized controlled trials, 3 retrospective chart reviews) satisfied selection criteria (n = 459). All studies employed different dosage categories: mean effective maintenance dose, mean initial dose, mean short-term and long-term dose, and mean daily dose. Dosage regimens were variable, with 0.45 to 1.1 g · kg · day for PEG3350 and 0.48 to 0.65 g · kg · day for PEG4000. Adverse effects were transient across all studies for all types of PEG; these included diarrhea and abdominal pain. This systematic review provided evidence for a lack of reported side effects from PEG for children aged younger than 24 months. Evidence to establish appropriate dosage regimens does not exist.An infographic accompanying this article can be found at http://links.lww.com/MPG/B839.

Performance evaluation of the different nano-enhanced polysulfone membranes via membrane distillation for produced water desalination in Sert Basin-Libya

A Polysulfone-Polyethylene glycol (PS/PEG) flat sheet membrane was prepared by phase inversion technique. Dimethyl Formamide (DMF) was utilized as a solvent and deionized water was utilized as the coagulant. Polyethylene glycol (PEG) of a various dose of PEG 2000 was utilized as the polymeric improvers and as a pore-forming agent in the casting mixture. The single-walled carbon nanotube (SWCNTs), multi-walled carbon nanotube (MWCNTs), aluminum oxide (Al2O3) and copper oxide (CuO) nanoparticles (NPs) were utilized to improve the PS/PEG membrane performances. The characterizations of the neat PS, PS/PEG, PS/PEG/Al2O3 (M1) PS-PEG/CuO (M2), PS-PEG/SWCNTs (M3) and PS/PEG/MWCNTs (M14) nanocomposite (NC) modified membranes were acquired via Fourier-transform infrared analysis (FTIR), water contact angle estimation (WCA), scanning electron microscope (SEM), dynamic mechanical analyzer (DMA) and thermogravimetric analysis (TGA). Enhanced Direct contact membrane distillation (EDCMD) unit was used for estimating the efficiency of the performance of the synthesized NC membranes via 60 °C feed synthetic water and/or saline oil field produced water samples containing salinities 123,14 mg/L. Adjusting the operational procedures and water characteristics confirmed a high salt rejection of 99.99% by the synthesized NC membranes. The maximum permeate flux achieved in the order of SWCNTs (20.91) > Al2O3 (19.92) > CuO (18.92) > MWCNT (18.20) (L/m2.h) with adjusted concentration of 0.5, 0.75, 0.75, 0.1 wt% compared with PS weight, i.e. 16%. The optimum operational circumstances comprised feed and permeate temperatures 60 °C and 20 °C, respectively. The achieved flux was 5.97 L/m2.h, using brine oil field produced water, via PS/PEG/SWCNTs membrane with 0.5 wt% of SWCNTs. Moreover, the membrane indicated sustaining performance stability in the 480 min continuous desalination testing, showing that the synthesized PS/PEG/SWCNTs NC modified membrane may be of magnificent potential to be activated in EDCMD procedure for water desalination.

Effects of Peg-Induced Drought Stress on Germination and Seedling Performance of Bread Wheat Genotypes

This study was conducted to determine the response of some bread wheat genotypes to drought stress during germination and seedling growth stages. Two bread wheat cultivars (Karatopak and Sagittoria) and three advanced breeding lines (SERI.1B*2/3KAUZ*2BOW//KAUZ, 89N2090/WERAVER// SW91.4903 and STAR’S’KAUZ’S’s) were used as the seed material. Three different doses of Polyethylene Glycol (Control, -0.6 MPa and -1.2 MPa of PEG-6000) were used to generate drought stress in germination and seedling growth stages of bread wheat. Germination experiments were carried out in petri dishes placed into an incubator with 4 replications in completely randomized factorial design. Seedling emergence experiments were carried out in plastic containers filled with a mixture of sand and peat placed into a growth cabinet with 3 replications in factorial arrangement of CRD. Germination experiments showed that genotype, PEG and genotype x PEG interactions were significant for examined traits except for germination rate. In the seedling experiments, genotype, PEG and genotype x PEG interaction were significant for all parameters, except for mean emergence time. Generally, increased doses of PEG caused remarkable decreases in all examined traits, but increase in mean germination time and mean emergence time. As the PEG doses increased, genotypes responded differently with regard to examined traits in germination and seedling emergence of bread wheat genotypes. It can be concluded that PEG-6000 was useful agent to create drought stress in germination and seedling growth of bread wheat, but greater doses and osmotic potentials lower than -1.2 MPa could be applied to better determine the drought stress tolerance of bread wheat genotypes.

518 Optimizing Inpatient Colonoscopy Preparation: A QI Project

INTRODUCTION: Hospitalization is an independent risk factor of poor bowel preparation and it has a lower procedure completion rate as compared to outpatients. Ineffective inpatient colonoscopy preparation may lead to delayed or canceled procedures which subject the patient to additional bowel preparation and sedation. Subsequently it results in patient inconvenience, increased cardio-pulmonary complications, longer hospital stays, and increased hospital cost. METHODS: Defining the problem: Chart review of the inpatient colonoscopies performed between May and July 2017 revealed that 4 liters-single dose polyethylene glycol–electrolyte lavage solution [PEG-ELS] was used in more than 90% of the inpatient colonoscopies. The percentage of colonoscopies with a rating of fair or poor was 36%. On average, 15% of patients failed inpatient bowel preparation. Aim of the project: To reduce the percentage of failed inpatient colonoscopies to less than 10% by May 2018 and to reduce the percentage of inpatients colonoscopies with an inadequate bowel preparation by 5% by May 2019. Interventions: 1) Fellows education on the evidence based split-dose regimen. 2) Bowel prep quality deemed adequate if cecal intubation was successful and prep was satisfactory to identify the targeted lesions. 3) Nothing by mouth orders to be started at 4 am or later instead of traditional after midnight orders. 4) Notify MD orders if the patient has any problem with the bowel prep to enhance communication with nurses. 5) As needed orders for nasogastric tube placement for administration of the prep. 6) An order set was implemented in Epic to facilitate the process and make it uniform. RESULTS: After the first PDSA cycle (Sep 2017-May 2018), we were able to reduce the percentage of failed inpatient colonoscopies from an average of 15% to less than 5% and we reduced the percentage of inadequate bowel prep by 4% (Goal of 5%). In the second PDSA cycle (May 2018-May 2019), we maintained the percentage of failed inpatient bowel preparation under 10% (4.2-7.5%) and reduced the percentage of inadequate bowel prep 17% from the baseline. CONCLUSION: Implementing a split-dose regimen of 4 liter PEG-ELS for all inpatient colonoscopies, improving communication between nurses and ordering physicians, and executing a standard order set for bowel prep orders and instructions are successful strategies in optimizing inpatient bowel preparation. The reliability of the bowel preparation quality scales needs to be validated for use in inpatient colonoscopies.

Can a 1-day clear liquid diet with a split -dose polyethylene glycol overcome conventional practice patterns during the preparation for screening colonoscopy?

A successful screening colonoscopy is closely linked to the quality of a bowel preparation. In this study, we aimed to determine the impact of a 1-day clear liquid diet (CLD) compared to a 3-day combined diet (CMD) accompanied by a split-dose regimen of polyethylene glycol and electrolyte lavage solution (PEG-ELS) for screening colonoscopy. This was a prospective, randomized, endoscopist-blinded study. Patients referred for screening colonoscopy were randomized to four groups as a 1-day CLD+PEG-ELS vs. a 1-day CLD+sulfate free (SF)-PEG-ELS and a 3-day CMD+PEG-ELS vs. a 3-day CMD+SF-PEG-ELS. An assessment of the quality of colon cleaning, tolerability to the preparation, and symptoms related to the preparation were recorded. A total of 506 patients were enrolled in this study. The quality of bowel preparation was significantly inferior in the CMD+PEG-ELS group than CLD+PEG-ELS (p=0.004) and CMD+SF-PEG-ELS groups (p=0.007). There were no statistical differences among the groups in terms of the polyp detection rate. With respect to an easy rating of diet following and the consumption of laxative, there were no significant differences among the four groups. Gastric fullness and nausea/vomiting were pointed out much more, especially in the SF-PEG-ELS users (p=0.008 and p=0.004, respectively). A 1-day CLD was not inferior to a 3-day CMD for colonoscopy preparation in terms of bowel cleaning, the polyp detection rate, and patient tolerance.

PEG vs. sennosides for opioid-induced constipation in cancer care.

This randomized double-blind, double-dummy, 2-treatment, 2-period crossover study aimed to compare the efficacy and tolerability of polyethylene glycol (PEG) and sennosides in ambulatory cancer patients with opioid-induced constipation. Outpatients ≥ 18years old with cancer, at risk of or already experiencing opioid-induced constipation, were randomly assigned to begin a standard bowel protocol of escalating doses of sennosides or PEG, plus a dummy preparation. After 3weeks, the patients switched to the alternate active product and dummy preparation. Constipation was assessed using the revised Victoria Bowel Performance Scale (rBPS) at the end of each of the 2 consecutive 21-day study periods for the number of days with a satisfactory bowel movement, the time in days to goal rBPS (G), and the treatment preference of each patient. Seventy patients were recruited, with 42 completing their first treatment period and 28 completing both treatment periods. For the typical patient, the expected number of days with a satisfactory bowel movement per days of treatment was found to be 1.21 times higher on PEG than on sennosides in a particular period (95% credible interval 0.96 to 1.55). Patients taking PEG were 1.47 times more likely to reach a rBPS of G before patients taking sennosides in the first period (95% confidence interval 0.74 to 2.94). There was no evidence of a difference in patient preference between laxatives. Our study found weak evidence that PEG is superior to sennosides with respect to overall effectiveness in cancer patients with opioid-induced constipation.

A Randomized Trial of Split Dose 3 L Polyethylene Glycol Lavage Solution, 2 L Polyethylene Glycol Lavage Combined With Castor Oil, and 1 L of Polyethylene Glycol Lavage Solution Combined With Castor Oil and Ascorbic Acid for Preparation for Colonoscopy.

Background: Castor oil (CaO) has the potential of halving the required volume of bowel preparation solution; however, no clinical trial investigated the efficacy of CaO on bowel preparation for colonoscopy in addition to polyethylene glycol (PEG).Objectives: Our aim was to evaluate efficacy and safety of lower dose PEG together with 30 mL CaO alone or plus ascorbic acid (Asc) in bowel preparation before colonoscopy.Methods: Two hundred and forty-six patients were allocated randomly to ingest 2 L PEG with 30 mL CaO, 1 L PEG with 30 mL CaO plus 5 g Asc, or 3 L PEG. We used Boston Bowel Preparation Scale (BBPS) to evaluate bowel preparation efficacy. We also determined other outcomes such as procedure time, polyp or adenoma detection rate, and adverse events (AEs).Results: Of 282 patients recruited, 36 were excluded. Groups were matched for baseline characteristics except weight (P = 0.020) and body mass index (BMI) (P = 0.003). Patient's satisfaction was higher in 2 L PEG-CaO (P = 0.016) and 1 L PEG-CaO-Asc groups (P = 0·017). Patients' compliance was 67.5, 71.4, and 80.5% in 3 L PEG, 2 L PEG-CaO, and 1 L PEG-CaO-Asc groups (P = 0.014). Adequate bowel preparation rate was 75, 78.57, and 53.66% in 3 L PEG, 2 L PEG-CaO, and 1 L PEG-CaO-Asc groups (P = 0.021). There were no differences in terms of remaining outcomes.Conclusions: Despite an increase in patients' satisfaction and compliance, 1 L PEG-CaO-Asc significantly decreased adequate bowel preparation rate. However, 2 L PEG-CaO improved the patients' satisfaction and compliance and increased adequate bowel preparation rate (Registration number, ChiCTR-IIR-17012418).