Oral Polyethylene Glycol Research Articles

A randomized, controlled trial to assess a novel colorectal cancer screening strategy: the conversion strategy: A comparison of sequential sigmoidoscopy and colonoscopy with immediate conversion from sigmoidoscopy to colonoscopy in patients with an abnormal screening sigmoidoscopy

OBJECTIVE: Our study was a randomized, controlled trial to assess a novel strategy that provides comprehensive colorectal cancer screening in a single visit versus traditional sigmoidoscopy and, where appropriate, colonoscopy on a subsequent day. METHODS: Consecutive patients referred for screening were randomized to control or so-called “conversion” groups. Patients in the control group were prepared for sigmoidoscopy with oral phospho-soda. Those with an abnormal sigmoidoscopy were scheduled for colonoscopy on a future day after oral polyethylene glycol preparation. In the conversion group, patients were prepared with oral phospho-soda. Patients with a polyp >5 mm or multiple diminutive polyps were converted from sigmoidoscopy to colonoscopy, allowing comprehensive screening in a single visit. Clinical outcomes were assessed by postprocedure physician and patient questionnaires. RESULTS: Two hundred thirty-five patients were randomized (control = 121, conversion = 114). In the control group, 28% had an indication for colonoscopy. Three of 33 (9%) with an abnormal sigmoidoscopy did not return for colonoscopy. At colonoscopy, 27% had a proximal adenoma. In the conversion group, 28% had an abnormal sigmoidoscopy and underwent conversion to colonoscopy. Forty-one percent undergoing colonoscopy in the conversion group had a proximal adenoma. Physicians reported no differences in preparation or procedure difficulty, whereas patients reported no differences in the level of comfort or overall satisfaction between groups. When queried regarding preferences for future screening, 96% chose the conversion strategy. CONCLUSIONS: The conversion strategy led to similar outcomes compared to traditional screening while improving compliance with colonoscopy in patients with an abnormal sigmoidoscopy.

The effect of condensed tannins in Lotus corniculatus upon reproductive efficiency and wool production in sheep during late summer and autumn

A grazing experiment, conducted for 55 days (from 4 March to 29 April) in the late summer/autumn of 1997, at Massey University, Palmerston North, New Zealand, compared the reproductive efficiency and wool growth of ewes grazing Lotus corniculatus (birdsfoot trefoil) or perennial ryegrass (Lolium perenne)/white clover (Trifolium repens) dominant pasture (pasture). Half the ewes grazing each forage were given daily oral polyethylene glycol (PEG: molecular weight 3500) supplementation to inactivate the condensed tannins (CT) in lotus. A rotational grazing system with 200 mixed age ewes (54·2±0·88 kg/ewe; 50 ewes/treatment) was used.The effect of forage species and PEG supplementation upon voluntary feed intake (VFI), concentration of plasma metabolites, reproductive efficiency, wool production and wool characteristics was measured during two synchronized oestrous cycles. The ewes were restricted to maintenance feeding for the first 12 days of each oestrous cycle and then increased to ad libitum for the 6 days prior to and including ovulation. Lotus contained 17 g total CT/kg dry matter (DM) in the diet selected. There were only trace amounts of total CT in pasture. In vitro organic matter digestibility (OMD) was higher for lotus (0·82 v. 0·74) than for pasture, whilst lotus contained less nitrogen (N; 37·8 v. 44·5 g/kg OM).Mean ovulation rates (OR) for CT-acting and PEG sheep grazing pasture and lotus were respectively 1·33 v. 1·35 and 1·78 v. 1·56, with corresponding lambing percentages being 1·36 v. 1·36 and 1·70 v. 1·42. Fecundity (number of corpora lutea/ewe ovulating) was greater for ewes grazing lotus than pasture (P<0·01), and tended to be greater for CT-acting than for PEG sheep grazing lotus (P=0·06). In unsupplemented sheep, ewes grazing lotus had increased plasma concentrations of branched chain amino acids (BCAA; 57%) and essential amino acids (EAA; 52%) compared to ewes grazing pasture.In ewes grazing pasture, PEG administration had no effect on plasma concentrations of urea and free amino acids, VFI, reproductive efficiency and wool production. However, in sheep grazing lotus, plasma concentrations of urea were significantly lower and concentrations of most amino acids were significantly higher for CT-acting than for PEG supplemented ewes (CT not acting); there was no difference in VFI between these two groups. Compared to ewes grazing pasture, ewes grazing lotus had similar VFI but produced more wool with longer staples and thicker fibre diameter, with there being no effect of PEG supplementation.It was concluded that feeding lotus increased the efficiency of both reproduction and wool production without an increase in VFI, and that a possible cause was the action of CT in increasing plasma EAA and especially BCAA concentration.

Effect of condensed tannins on the production of wool and on its processing characteristics in sheep grazing Lotus corniculatus

The effect of condensed tannins (CT) in Lotus corniculatus upon voluntary feed intake (VFI), concentration of rumen and plasma metabolites, production of wool, and wool processing characteristics was measured in grazing ewes restricted to maintenance feeding for 125 days during summer. A rotational grazing system with restricted feed allowance with 40 mixed aged dry ewes (54±1·0 kg) was used. Half of the ewes were selected randomly for twice-daily oral polyethylene glycol (PEG; MW 3500) supplementation (CT-inactivated), with the remainder being CT-acting animals. Measurements of the diet selected, VFI, wool production, and wool processing characteristics were made. The concentration of ammonia in rumen fluid and the concentrations of methionine, cysteine, and urea in blood plasma were also measured. The diet selected contained 32 g total nitrogen (N) and 28 g total CT/kg dry matter (DM) and had an in vitro organic matter digestibility of 0·70. Action of CT reduced rumen ammonia concentration (256 v. 302 mg N/L), reduced blood plasma urea concentration (7·3 v. 8·9 µM), and increased blood plasma cysteine concentration (30 v. 27 µM) compared with sheep receiving PEG supplementation. CT had no effect on VFI but increased clean fleece weight (2·53 v. 2·28 kg/ewe) and staple length (7·7 v. 6·9 cm), but did not affect liveweight gain (54 v 67 g/day). The CT reduced dag weight and tended to reduce wool yellowness relative to sheep receiving PEG. There were no signifiant effects of CT on fibre diameter, staple strength, bulk density, and wool resilience. It was concluded that action of CT in sheep fed L. corniculatus reduced the degradation of forage protein in the rumen and the principal effect of this was to increase the efficiency of wool production, with more wool being produced at the same feed intake and the wool being of reduced yellowness.

A prospective blinded randomized trial comparing oral sodium phosphate and polyethylene glycol solutions for bowel preparation prior to barium enema

Purpose: A prospective blinded randomized trial to compare oral sodium phosphate (NaP) solution with polyethylene glycol (PEG) preparations as bowel preparation prior to barium enema examination. Patients and Methods: One hundred and ten patients consented to take part and each patient was randomly asigned to receive either NaP (Oral Fleet Prep) or PEG (Lyteprep). The barium enemas were reviewed by two radiologists blinded to the type of bowel preparation the patient had received. The colon was divided into six segments and each segment was assessed for the amount of stool and water present, the adequacy of coating, the ability to exclude inflammatory bowel disease and the presence of polyps. A score of 0–3 (failure to good) was assigned per segment on each of these criteria. Results: The average individual score for the NaP group was 89.2. The average individual score for the PEG group was 88.81. No significant difference was found in the quality of bowel cleansing between the two agents. In particular there was no significant difference in the scores for water retention (two-tailed P = 0.748) and the difference for the quality of coating was considered not quite significant (two-tailed P = 0.0818). Conclusion: Oral sodium phosphate cleans the colon as well as polyethylene glycol solutions. The use of NaP will result in significant cost savings and improved patient compliance.

Current practices of preoperative bowel preparation among North American colorectal surgeons.

In North America, the rate of infections following colorectal surgery decreased after the introduction of oral antibiotic bowel preparation against colonic microflora. Eight hundred eight board-certified colorectal surgeons were surveyed for their current bowel preparation practices before elective procedures. The 471 responders (58%) all use mechanical preparation: oral polyethylene glycol solution (70.9% of the respondents), oral sodium phosphate solution with or without bisacodyl (28.4%), and "traditional" methods of dietary restriction, cathartics, and enemas (28.4%). Most surgeons (86.5%) add oral and parenteral antibiotics to the regimen; 11.5% add only parenteral antibiotics, 1.1% add only oral antibiotics, and 0.9% add no antibiotics. Generally (77.8% of cases), oral neomycin and erythromycin or metronidazole are combined with a perioperative parenteral antibiotic. Most individuals start the preparation as outpatients the day before surgery, and the parenteral drugs are added to the regimen 1-2 hours before the procedure. The use of outpatient bowel preparation is increasing; however, patient selection is critical, and education is needed to reduce the rate of complications.

Is coloscopic preparation with oral Polyethyleneglycol 2 hours before general anesthesia safe in ambulatory patients?

Is coloscopic preparation with oral Polyethyleneglycol 2 hours before general anesthesia safe in ambulatory patients?

The role of condensed tannins in the nutritional value of Lotus pedunculatus for sheep. 5. Effects on the endocrine system and on adipose tissue metabolism.

1. Three experiments were conducted using Lotus pedunculatus containing high concentrations of condensed tannins (CT), and utilizing the principle that polyethylene glycol (PEG) application (molecular weight 3350) will irreversibly bind a portion of the CT and thus reduce the dietary reactive (i.e. non-PEG bound) CT concentration. Lotus diets containing 95, 45 and 14 g total reactive CT/kg dry matter (DM), induced by spraying with three PEG rates, were given to sheep at hourly intervals (600 g DM/d) for 21 d (Expt 1). In Expts 2 and 3, lambs grazed areas oversown with either lotus (89 g CT/kg DM) or clovers (Trifolium repens and Trifolium pratense; less than 1 g CT/kg DM) for 42 and 92 d respectively. In Expt 2 half the animals grazing each forage received oral PEG (75 g/d), whilst in Expt 3 half the lambs were sired by rams selected respectively for low or high levels of subcutaneous fat deposition. 2. Hormone concentrations in plasma (Expt 1 only) were determined by radioimmunoassay. Rates of [U-14C]-acetate and D-[U-14C]glucose incorporation and oxidation by subcutaneous and abdominal adipose tissue removed at slaughter, together with rate of glycerol release, were determined during in vitro incubation in all three experiments. 3. Plasma concentration of growth hormone was positively and linearly related to dietary reactive CT concentration, whilst 3,5,3'-triiodothyronine (T3) concentration tended to be negatively and linearly related to dietary reactive CT concentration. Diet CT concentration had no effect on plasma concentrations of the other hormones measured.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral polyethylene glycol's inhibitory effect on the subcutaneous growth of Ehrlich's carcinoma in mice, and on the local inflammatory response to the tumour.

Oral polyethylene glycol's inhibitory effect on the subcutaneous growth of Ehrlich's carcinoma in mice, and on the local inflammatory response to the tumour.