Morbidity Andmortality Research Articles

Protective Effects of Idebenone against Sepsis Induced Acute Lung Damage

Background/Aims Sepsis is an uncontrolled systemic infection, withcomplex pathophysiology that may result in acute lung organ damage and cause multiple organ failure. Although much research has been conducted to illuminate sepsis’s complex pathophysiology, sepsis treatment protocols are limited, and sepsis remains an important cause of mortality andmorbidity in intensive care units.Various studies have shown that idebenone (IDE) possesses strong antioxidant properties, which inhibit lipid peroxidation and protect cells from oxidative damage. The present study aimed to evaluate the protective effects of IDE against lung injury in a cecal ligation and puncture (CLP)-induced sepsis rat model. Methods Male albino Wistar rats were used. The animals were divided into a healthy control (no treatment), CLP, IDE control (200 mg/kg), and CLP + IDE subgroups (50 mg/kg, 100 mg/kg, and 200 mg/kg), with nine rats in each group.IDE was administered 1 h after CLP induction.To evaluate the protective effects of IDE, lung tissues were collected 16 h after sepsis for biochemical, immunohistochemical staining, and histopathological examination. Results IDE significantly ameliorated sepsis-induced disturbances in oxidative stress-related factors, with its effects increasing in accordance with the dose.IDE also abolished histopathological changes in lung tissues associated with CLP.Furthermore, interleukin 1 beta (IL-1β)and tumor necrosis factor-alpha (TNF-α) immunopositivity markedly decreased in the septic rats following IDE treatment. Conclusions IDE largely mitigated the inflammatory response in sepsis-induced lung injury by decreasing free radicals and preventing lipid peroxidation. The results suggest that IDE may represent a potential novel therapeutic drug for sepsis treatment.

Questions and Controversies in the Clinical Application of Tyrosine Kinase Inhibitors to Treat Patients with Radioiodine-Refractory Differentiated Thyroid Carcinoma: Expert Perspectives.

Notwithstanding regulatory approval of lenvatinib and sorafenib to treat radioiodine-refractory differentiated thyroid carcinoma (RAI-R DTC), important questions and controversies persist regarding this use of these tyrosine kinase inhibitors (TKIs). RAI-R DTC experts from German tertiary referral centers convened to identify and explore such issues; this paper summarizes their discussions. One challenge is determining when to start TKI therapy. Decision-making should be shared between patients and multidisciplinary caregivers, and should consider tumor size/burden, growth rate, and site(s), the key drivers of RAI-R DTC morbidity and mortality, along with current and projected tumor-related symptomatology, co-morbidities, and performance status. Another question involves choice of first-line TKIs. Currently, lenvatinib is generally preferred, due to greater increase in progression-free survival versus placebo treatment and higher response rate in its pivotal trial versus that of sorafenib; additionally, in those studies, lenvatinib but not sorafenib showed overall survival benefit in subgroup analysis. Whether recommended maximum or lower TKI starting doses better balance anti-tumor effects versus tolerability is also unresolved. Exploratory analyses of lenvatinib pivotal study data suggest dose-response effects, possibly favoring higher dosing; however, results are awaited of a prospective comparison of lenvatinib starting regimens. Some controversy surrounds determination of net therapeutic benefit, the key criterion for continuing TKI therapy: if tolerability is acceptable, overall disease control may justify further treatment despite limited but manageable progression. Future research should assess potential guideposts for starting TKIs; fine-tune dosing strategies and further characterize antitumor efficacy; and evaluate interventions to prevent and/or treat TKI toxicity, particularly palmar-plantar erythrodysesthesia and fatigue.

Impact of Intestinal Parasite/Malaria Co-Infection on Haemoglobin in Patients of Melong and Denzo Health Facilities, Littoral Region, Cameroon

Objective: To assess the impact of intestinal parasite/malaria co-infection on haemoglobin in patients of Melong and Denzo health facilities, Littoral region, Cameroon. Materials and methods: This study took place from November 2019-March 2020. Blood samples were collected from patients after informed consent by finger pricking. Stool samples were examined using normal saline and the Kato-Katz technique for the presence and intensity of IPs. Thick blood films were prepared, Giemsa-stained and examined under x100 to detect the presence of parasites and estimate GMPD. Hb values were determined using a haemoglobinometer. Data was analysed using SPSS version 23 and the significance level was set at P<0.05. Results: The overall prevalence of IP was 28.3% (113/400). Entamoeba histolytica was the most prevalent IP 22.0% (88/400) while Taenia spp 0.3% (1/400) and Trichuris trichiura 0.3% (1/400) recorded the lowest prevalences. E. histolytica was significantly more in Melong (27.7%, 76/274) than in Denzo (9.5%, 12/126), (P=0.001). Ascaris lumbricoides was significantly more in Denzo (10.3%, 13/126) than in Melong (0.3%, 1/274), P=0.001. Trichomonas hominis was the only parasite which was significantly different (p=0.009) between age groups. The overall prevalence of malaria was 66.5% (266/400). The prevalence of malaria was higher in Denzo (79.3%, 100/126) than in Melong (60.5, 166/274), P=0.001. Children ≤ 5 years recorded the highest (75.4%, 83/110) prevalence of malaria, and the difference between age groups was significant, p=0.016. The overall prevalence of co-infection and anaemia were 16.3% (65/400) and 58.8% (235/400), respectively. Higher prevalence (20.6%, 37/180) of intestinal parasites/ malaria was seen in anaemic patients than in non-anemic (12.7%, 28/220), p=0.035. Conclusion: Malaria was a strong predictor of anemia and the malaria intensity was highly correlated with anemia in patients from Melong and Denzo localities. Interventions targeting groups at risk will help reduce morbidity and mortality caused by these diseases in Melong and Denzo localities.

DNA Methylation Markers in Lung Cancer

Lung cancer is the most common cancer and the leading cause of cancer-related morbidity and mortality worldwide. As early symptoms of lung cancer are minimal and non-specific, many patients are diagnosed at an advanced stage. Despite a concerted effort to diagnose lung cancer early, no biomarkers that can be used for lung cancer screening and prognosis prediction have been established so far. As global DNA demethylation and gene-specific promoter DNA methylation are present in lung cancer, DNA methylation biomarkers have become a major area of research as potential alternative diagnostic methods to detect lung cancer at an early stage. This review summarizes the emerging DNA methylation changes in lung cancer tumorigenesis, focusing on biomarkers for early detection and their potential clinical applications in lung cancer.

Evaluation of Ventilator Associated Respiratory Tract Infections (VARTI) by Common Anaerobic and Atypical Bacteria among the Patients of ICU of a Tertiary Care Hospital in Bangladesh

Background and aim of the study:Ventilator-associated respiratory tract infection (VARTI)is theleading cause of higher mortalityand morbidity in ICU compared to non-ICU patients. Thisarticlereveals etiology of VARTI by commonanaerobic and atypical bacteria in ICU of Dhaka Medical College. Materials and Methodology: This is a cross-sectionalstudy where 200 endotracheal aspirate (ETA)samples were taken from clinically suspected patients of VARTI. After proper screening,bacteria were identified by PCR as because anaerobic and atypical bacteria cannot be easily grown inconventional culture media. Result: Sixty three (31.5%) samples were found to have VARTI. Among the common atypicalbacteriacausing, M. pneumoniae was found in 4 (6.35%) and L. pneumophila in 2 (3.17%) of the 63 samples. Insearch of the anaerobic bacteria causing VARTI,Peptostreptococcus was detected in 3 (4.76%) whileFusobacterium nucleatum andPrevotella melaninogenicawere detected in 2 (3.17%) each of the 63 samples. Conclusion: Anaerobic and atypical bacteria are implicated in VARTI in ICU although at a relative lowrate. JBSA 2021; 34(1): 32-37

Inclusion of Phytogenic Feed Additives in Diet of Growing Rabbits: Effects on Antioxidant Enzymes and Immunoglobulins

A part of rabbit farms profitability depends on the efficacy of weanling rabbits to grow efficiently and to rescue from morbidity and mortality during the fattening period...

Socio-Demographic Profile of Fatal Poisoning in a Tertiary Care Teaching Hospital of Coimbatore District-A Retrospective Study

Background: Poisoning poses a major public health problem mainly in developing countries. Because ofthe rapid industrialization and advancement in agricultural sector, fatality by poisoning also increases dayby day. The aim of this study is to determine the socio-demographic profile of fatal poisoning in CoimbatoreDistrict. Methods: This retrospective study was carried out in Department of Forensic Medicine, CoimbatoreMedical College, Coimbatore, Tamil Nadu with data obtained from fatal poisoning cases brought forpostmortem examination from January 2016 to December 2016. Identification of specific poisons were donewith chemical examiner’s report. All collected data were analyzed in various possible aspects in the preparedproforma. Results: During the study period the total number of medico legal autopsies conducted were 3675out of which fatal cases due to poisoning were 600(16.33%) cases. The study showed that the incidence ofpoisoning was more common among married men ie.303 cases (50.5%) out of 600 total number of poisoncases. The incidence was more common in the age group 31 – 40 years in males (86 cases) which formed14.3 % and in females it is 21-30 years (65 cases) which formed 10.8%.When we observed the religion wisedistribution, Hindu males out numbered 369 out of 600 cases which formed 61.5%. Conclusion: Morbidityand mortality due to poisoning can be minimized by health education, early referral, establishment oftoxicological units for detection of specific poisons and appropriate guidance for proper management ofpoisoning cases at hospitals and primary health care centers.

Laparoscopic appendectomy as an index procedure for surgical trainees: clinical outcomes and learning curve

Surgical training is essential to maintain safety standards in healthcare. The aim of this study is to evaluate learning curves and short-term postoperative outcomes of laparoscopic appendectomy (LA) performed by trainees(TRN) and attendings(ATT). The present study included the medical records of patients with acute appendicitis who underwent a fully LA in our department between January 2013 and December 2018. Cases were divided into trainees (TRN and ATT groups based on the experience of the operating surgeon. The primary outcome measures were30-day morbidityand mortality. Preoperative patients' clinical characteristics, intraoperative findings, operative times, and postoperative hospitalization were compared. Operative times were used to extrapolate learning curves and evaluate the effects of changes in faculty using CUSUM charts. A propensity score matching analysis was performed to reduce differences between cohorts regarding both preoperative characteristics and intraoperative findings. A total of 1173 patients undergoing LA for acute appendicitis were included, of whom 521 (45%) in the TRN group and 652 (55%) in the ATT group. No significant differences were found between the two groups in terms of complication rates, operative times and length of hospital stay. However, CUSUM chart analysis showed decreased operating times in the TRN group. Operative times improved more quickly for advanced cases. The results of this study indicate that LA can be performed by trainees without detrimental effects on clinical outcomes, procedural safety, and operative times. However, the learning curve is longer than previously acknowledged.

COVID-19 Pandemic in African Union Member Nations: An Epidemiological Overview

Background: Despite the fragile health systems in Africa, the continent remains less impacted by COVID-19 pandemic with no clear understanding of the distributional patterns across the countries and regions. This study assessed the distribution patterns of COVID-19 infection and the associated epidemiologic measures across five geographical regions and the 53 African Union (AU) member countries.Methods: The COVID-19 infection data obtained from the Africa CDC website (www.africacdc.org) and covering the period from February 2020 to January 2021 was used for this study. We conducted descriptive and inferential analyses of the reported cases, deaths, active cases, recoveries and epidemiologic measures that included morbidity and mortality rates (MMR), case fatality rate, and case ratios.Results: A total of 3,196,589 SARS-CoV-2 sero-positive cases was reported in AU during the period under review, out of which, 77,486 died, 536,784 remained active cases and 2,582,372 recovered. The mean CFR in AU was 2.21%. The Southern region recorded the highest average reported cases (149,314), active cases (26,156), and deaths (3,942), while the Northern region recorded the highest average recoveries (121,372). Conversely, the central region recorded the least average number of reported cases (4,978), recoveries (4,554), and deaths (191), while the western region logged the least average number of active cases (2,274). Conclusion: The Northern and Southern African regions were worse hit than other regions. However, there is need to scale up laboratory testing for SARS-CoV-2 in other regions of AU to enhance proper case ascertainment, tracing, and treatment of COVID-19 cases in a timely manner.

Prevalence of Functional Limitation in COVID-19 Recovered Patients Using the Post COVID-19 Functional Status Scale.

COVID-19 is an emerging global health pandemic causing tremendous morbidity and mortality worldwide. Chronic symptoms progressing to poor functional status have been reported in a substantial proportion of COVID-19 patients worldwide. This study aimed to determine the prevalence of functional limitation in COVID-19 recovered patients using the post-COVID-19 functional status scale. A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. COVID-19 recovered patients with reverse transcription-polymerase chain reaction negative status were included and assessed using the post-COVID-19 functional status scale. Data entry and analysis was done in Statistical Package for the Social Sciences version 20.0. Descriptive statistics were performed. A total of 106 patients were included for the final analysis. More than half of the patients (56.6%) reported having no functional limitation (grade 0), while the prevalence of some degree of functional limitation was observed in 46 (43.4%) patients (grade 1 to 4). Some form of functional limitation should be anticipated after COVID-19 infection. Post-COVID-19 functional status scale can be a valuable tool in determining the prevalence of functional limitation in COVID-19 recovered patients in acute health care settings. It can potentially guide in planning rehabilitative measures in post-acute care management of COVID-19 survivors.

Adenocarcinoma of the Appendix in Elderly: Diagnostic Dilemma

Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, the majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to the emergency (ER) with signs and symptoms mimicking acute appendicitis. Laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent for pathology lab and a diagnosis of adenocarcinoma of the appendix was made.

РЕВМАТОИДНЫЙ АРТРИТ И ПОРАЖЕНИЕ СЕРДЦА – ЭТО ДЕЙСТВИТЕЛЬНО АКТУАЛЬНО?

The article presents data on clinically significant heart impairment in pa- tients with rheumatoid arthritis (RA), as well as features of the development of ischemic and non-ischemic heart disease with a significant increase in the risk of adverse cardiovascular events. Patients with RA are characterized by an increased risk of developing myocardial infarction, heart failure, rhythm disturbances, sudden cardiac death, and general cardiovascular death. The paper emphasizes the possibility of a fairly rapid development of myocardial dysfunction in patients with RA from the moment of manifestation of the disease, the develop- ment and progression of atherosclerosis of the coronary arteries. Besides, in case of the development of a coronary artery disease in RApatients, theworst survival rate after aheart attack wasestablished. The available findings suggest that rheumatoid arthritis is adisease that makesa significant contribution to cardiovascular morbidity andmortality.

Telescopic Invagination Transpancreatic End-to-end Pancreatojejunostomy

Background: Postoperative pancreatic fistula is the main cause of operative morbidity andmortality in patients who undergo pancreatoduodenectomy. Various pancreatoenteric anastomosis techniques have been reported to minimize the postoperative fistula rate. No consensus exists regarding the most effective form of pancreaticojejunostomy. In this presentation the telescopic invagination transpancreatic end-to-end pancreatojejunostomy is described. Method: Especially in soft pancreas we are using the telescopic invagination method. We are using two double-armed PDS mattress sutures going through two layers of jejunum making an intestinal cuff, after that through the pancreas, another two layers of jejunum and the same on the way back. After suturing the invagination is created. Another two PDS sutures on the edges of anastomosis are usually sufficient. Results: There were 81 pancreatoduodectomies in 3 years provided in our surgery, 10 of these were operated with described telescopic method (one surgeon). In this group the rate of pancreatic fistula is 10%, in other group (different methods and surgeons) the pancreatic fistula rate is 21%. Conclusion: Telescopic invagination transpancreatic end-to-end pancreatojejunostomy seems to be good technique. Further studies with more patients are needed.

Pulmonology service staff N orth­Western Federal District in 2015–2019

Introduction. Prior to detailed review of the North- West Federal District (NWFD) pulmonology service per- formance during the COVID-19 pandemic, it is especial- ly worthwhile to evaluate its human resourcing in the prepandemic period of 2015–2019, since the perfor- mance of pulmonology service largely depends on its staffing, moreover in conditions of restructuring and decreased number of pulmonology bedspace in hospi- tals. Мethods. In the course of the study, the authors have analysed human resourcing data for pulmonology profile within the state healthcare system in NWFD for the period of 2015–2019. The results were statistically processed and data analysis carried out using Micro- soft Office Excel and SPSS software. Results . In the state healthcare system medical institutions of the NWFD throughout 2015–2019, the number of regular pulm- onologists’ positions fluctuated unrhythmically. The number of pulmonologists (MDs) in NWFD grew 0.82% during the period of 2015–2019, for comparison, in the Russian Federation the growth for the same period was 32.08%. The number of operating pulmonology depart- ments remained practically the same, but the number of occupied positions constantly changed. Practically all the pulmonologists in the NWFD have a specialist certi- ficate, but the share of doctors with qualification grade remains insufficient, and is on the decrease. Statistical analysis demonstrated significant positive Pearson cor- relation between the number of pulmonologists and general respiratory incidence (0.74 р=0.04), mortality (0.756 р=0.003), and the number of occupied pulmo- nology bedspace (0.619 р=0.024). Conclusion. Today, pulmonology service human resourcing review is to be conducted taking into account respiratory morbidity and mortality and the need for pulmonology services among the general population. Currently, there is no sci- entifically justified regulatory framework for the deve- lopment of the pulmonology service in NWFD regions, while the work of such services depends very much on the regional budgets and medical services’ tariffs. The development and fast implementation of such compre- hensive measures as salaries’ increase, adequate social support, regular residential and non-residential courses of continuous medical education, professional networ- king, etc. will allow to maintain and holistically develop the human potential of the NWFD pulmonology service.

The review of admissions of oncologic patients to emergency service: A cross-sectional study

Aim: Oncological emergencies constitute a considerable part of emergency admissions. The early and correct diagnosis ofoncological emergencies increases both life quality and decreases mortality rate due to oncologic emergency. In this study, weevaluated the admissions of oncologic patients to emergency service.Materials and Methods: This study was conducted retrospectively and patients with cancer admitted to emergency service of thirddegree university hospital between October 2012-2013. Demographic characteristics of the patients, the frequency of admission,admission time, diagnosis, co morbid diseases, and treatment process were investigated.Results: In the study 1472 admission that belongs to 593 patients are assessed. 59,2 % of patients are male, 40.8 % of patientsare female. Mean of age is 62. Repeated admission rate is 55.81%. The two most frequent complaints are dyspnea 14.2% andstomachache 10.4%. The two most common types of cancer were lung (19.73%) and stomach (12.47%) cancer. While 64.90% ofpatients were discharged, 33.80% of patients are hospitalized. The mortality rate in emergency service was 0.1%.Conclusions: Distinguishing the oncological from other emergencies will contribute to patients in terms of reducing mortality andmorbidity.

Inflammatory Markers in Cardiovascular Disease; Lessons Learned and Future Perspectives.

Cardiovascular disease (CVD) still remains the leading cause of morbidity and mortality worldwide. It is now established that inflammation plays a crucial role in atherosclerosis and atherothrombosis, and thus, it is closely linked to cardiovascular disease. The aim of the present review is to summarize and critically appraise the most relevant evidence regarding the potential use of inflammatory markers in the field of CVD. We conducted a comprehensive research of the relevant literature, searching MEDLINE from its inception until November 2018, primarily for meta-analyses, randomized controlled trials and observational studies. Established markers of inflammation, mainly C-reactive protein, have yielded significant results both for primary and secondary prevention of CVD. Newer markers, such as lipoprotein-associated phospholipase A2, lectin-like oxidized low-density lipoprotein receptor-1, cytokines, myeloperoxidase, cell adhesion molecules, matrix metalloproteinases, and the CD40/CD40 ligand system, have been largely evaluated in human studies, enrolling both individuals from the general population and patients with established CVD. Some markers have yielded conflicting results; however, others are now recognized not only as promising biomarkers of CVD, but also as potential therapeutic targets, establishing the role of anti-inflammatory and pleiotropic drugs in CVD. There is significant evidence regarding the role of consolidated and novel inflammatory markers in the field of diagnosis and prognosis of CVD. However, multimarker model assessment, validation of cut-off values and cost-effectiveness analyses are required in order for those markers to be integrated into daily clinical practice.

Knowledge of Women about the Early Detection Methods of Cervical Cancer in Baghdad City

Background: Cervical Cancer is considering a public health problem, leading cause of mortality andmorbidity among women.Objective: To assess women’s knowledge regarding cervical cancer and. early detection methodsMethodology: A descriptive study was conducted, included (200) women from different levels of educationwho work in the institute, from 5th November 2018 to 30 April 2019, by using interview technique and selfreporting technique . A non-probability (purposive) sample of (200) women. The questionnaire was usedfor data collection. The validity was estimated through a penal of experts related to the field of study, and sous the reliability was evaluated through a pilot study conduct included (10) women (except from the originalsample). Data is analyst through the implementation of descriptive and inferential statistical analysis.Results: The results of this study show that the knowledge of the study sample was low regarding earlydetection methods, prevention treatment and there was statistical significant relationship between level ofknowledge, and some variablesRecommendations: It was recommended that increase coverage in cervical screening programs from Iraqministry of health to encourage women in Iraq. In addition, training program should supply in educationalinstitute

PathFinder: Bayesian inference of clone migration histories in cancer.

Metastases cause a vast majority of cancer morbidity andmortality. Metastatic clones are formed by dispersal of cancer cells to secondary tissues, and are not medically detected or visible until later stages of cancer development. Clone phylogenies within patients provide a means of tracing the otherwise inaccessible dynamic history of migrations of cancer cells. Here, we present a new Bayesian approach, PathFinder, for reconstructing the routes of cancer cell migrations. PathFinder uses the clone phylogeny, the number of mutational differences among clones, and the information on the presence and absence of observed clones in primary and metastatic tumors. By analyzing simulated datasets, we found that PathFinder performes well in reconstructing clone migrations from the primary tumor to new metastases as well as between metastases. It was more challenging to trace migrations from metastases back to primary tumors. We found that a vast majority of errors can be corrected by sampling more clones per tumor, and by increasing the number of genetic variants assayed per clone. We also identified situations in which phylogenetic approaches alone are not sufficient to reconstruct migration routes.In conclusion, we anticipate that the use of PathFinder will enable a more reliable inference of migration histories and their posterior probabilities, which is required to assess the relative preponderance of seeding of new metastasis by clones from primary tumors and/or existing metastases. PathFinder is available on the web at https://github.com/SayakaMiura/PathFinder.

Thymosin α1; Potential Therapeutic Implications of an Immunoregulatory Drug in the Treatment of Lymphocytopenia Associated with COVID-19

It is not unbeknownst to us that since the very onset of the COVID-19 outbreak, many patients from different age groups have suffered greatly, and in a remarkable number of cases, succumbed to their untimely demise as a result of infection with the novel coronavirus or SARS-CoV- -2. The elderly are perhaps the most vulnerable community, who stand at the pinnacle of morbidity and mortality rates due to contracting severe forms of COVID-19. Hopefully, based on the recent findings and the present evidence, there might be a number of medications that would possibly be of great prophylactic and therapeutic value to the elderly patients diagnosed with COVID-19. According to an interventional study, Thymosin α1 is arguably one such medication that has recently been indicated to be an effective therapeutic agent for inpatient management of lymphocytopenia and T cell exhaustion caused by COVID-19.

No inferioridad entre dos agentes de bajo volumen (Picosulfato de Sodio/Citrato de Magnesio vs. Sulfato de Sodio/Potasio/Magnesio) en la preparación de colon para procedimientos diagnósticos: estudio observacional

Introducción: el cáncer colorrectal es un problema de salud pública; sin embargo, la detección temprana reduce su morbimortalidad. La colonoscopia es el procedimiento de elección para detectar lesiones premalignas y el éxito depende de una limpieza adecuada. El objetivo es evaluar el desempeño de dos preparaciones de bajo volumen empleados en un hospital de alto nivel.&#x0D; Materiales y métodos: estudio prospectivo en adultos que asistieran a colonoscopia en la Fundación Santa Fe de Bogotá, Colombia. Las preparaciones se evaluaron con la escala de Boston, con puntaje ≥ 6 puntos para una limpieza adecuada. Se realizó un análisis de regresión logística para establecer la efectividad de los medicamentos con un cálculo de no inferioridad del 3 %-5 %.&#x0D; Resultados: 598 pacientes fueron evaluados. El 49 % (293) fue expuesto al picosulfato de sodio/citrato de magnesio y el 51 % (305) fue expuesto al sulfato de sodio/potasio/magnesio. Con un promedio de Boston de 6,98 ± 1,86 (78 % con puntaje de Boston ≥ 6) y 7,39 ± 1,83 (83 %), respectivamente (p = 0,649). Según el análisis de la presencia y frecuencia de síntomas no deseados, el picosulfato fue mejor tolerado (p &lt; 0,001).&#x0D; Conclusiones: los estudios de preparación intestinal en pacientes de un escenario real son muy escasos.Los medicamentos de bajo volumen obtuvieron una efectividad global y por segmento de colon similar, confirmando la no-inferioridad; el picosulfato de sodio/citrato de magnesio fue mejor tolerado. Un estudio de costo-efectividad podría definir esto según las necesidades de la población de estudio.