Presence Of Mucosal Injury Research Articles

English

BACKGROUND The selective alpha-blockers are widely used in the clinical treatment for ureteral stones as MET (Medical Expulsive Therapy). American Urological Association and European Association of Urology, strongly recommend that patients with ureteral stones be alpha-blockers to promote stone passage. Due to the physiological effect of alpha-blockers on the ureter, researchers hypothesized that the use of alphablockers before ureteroscopy may help during the Ureteroscopic procedures, making it easier and safer. One critical step in doing ureteroscopy is directing scope into vesicoureteral junction as most of the time its non-dilated and this is place injury and later stricture chances are high which lead to failure of treatment.3 But in literature, there is a discrepancy with this hypothesis as some studies have failed to demonstrate the benefits of technical ease and lower complication rate with alpha-blocker being used in the preoperative period. METHODS We conducted a cross sectional study in the department of urology from January 2019 to January 2020. 30 patients of ureteric calculus on alpha-blocker therapy and 30 patients of BPH on alpha-blocker ± 5 alpha reductase therapy were included for study. During URSL (Ureteroscopic Lithotripsy) we used 6 / 7.5 fr URS (Ureterorenoscope), ease of admitting URS in vesicoureteral junction noted. The need for ureteral dilator for admitting URS, presence of mucosal injury, and bleeding or false passage noted as difficulty in instrumentation. And documentation of finding done in excel. RESULTS Out of 60 patients, 24 (40 %) patients didn’t need dilatation of ureteric orifice and Ureteroscopy was done easily among which 8 (33.33 %) were BPH patient and 16 (66.66 %) were ureteric calculus patient this difference is statistically significant with p-value 0.010. 36 (60 %) patients needed dilatation of ureteric orifice to facilitate URS of which 22 (61.11 %) patients were from the BPH group and 14 (38.88 %) are ureteric calculus group. The study shows a statistically significant difference with p-value 0.029. CONCLUSIONS Our study demonstrates that alpha-blockers failed to show a statistically significant difference in relaxation of the ureteric orifice in non-ureteric calculus patients. Further large group, multi-centric studies are required to find a definitive role for alpha blockers prior to URS. KEYWORDS BPH, Silodosin, Ureteroscopy, Ureteric Orifice, Alpha Blocker, Alpha 1a, Medical Expulsion Therapy

Outcomes variability in non-emergent esophageal foreign body removal: Is daytime removal better?

ObjectiveThe objective of this study is to investigate differences between esophageal foreign body removal performed during standard operating room hours and those performed after-hours in asymptomatic patients. MethodsA retrospective chart review at a tertiary children's hospital identified 264 cases of patients with non-emergent esophageal foreign bodies between 2006 and 2011. Variables pertaining to procedure and recovery times, hospital charges, complications, length of stay, American Society of Anesthesiology (ASA) classification, and presence of mucosal injury were summarized and compared between cases performed during standard operating hours and those performed after-hours. ResultsCases performed during standard hours had significantly longer average wait times compared with after-hours cases (13.1h versus 9.0h, p<0.001). No other clinical characteristics or outcomes were significantly different between groups. Longer wait times are not associated with mucosal injury or postoperative complications. ConclusionThere were no significant differences in procedure time, charges, or safety in after-hours removal of non-emergent esophageal foreign bodies compared to removal during standard operating hours. OR wait time was about 4h longer during standard hours compared with after-hours. This study could not assess the factors to determine the impact in differences in hospital resource utilization or work force, which may be significant between these two groups.

Human Intestinal Disaccharidase Activities

SummaryThe relationship between intestinal morphology, disaccharidase activity, and disaccharide absorption is controversial. A retrospective study of 798 consecutive biopsies was performed to determine whether disaccharidase activities varied by subject age, biopsy technique, and degree of villus atrophy. Lactase activity was inversely correlated with age in the absence or presence of villus atrophy; sucrase, maltase, and palatinase activities did not correlate with age. Biopsies obtained by capsule or endoscopy had similar disaccharidase activities. In subjects 24 months of age or younger, the degree of mucosal injury was inversely correlated with lactase activity. In subjects older than 24 months, the degree of mucosal injury was inversely correlated with maltase and, to a lesser extent, lactase activities. The data suggest that disaccharidase activities in mucosal biopsies, whether obtained by endoscopy or capsule, are diminished in the presence of mucosal injury and correlate inversely with the degree of injury.

Human Intestinal Disaccharidase Activities

The relationship between intestinal morphology, disaccharidase activity, and disaccharide absorption is controversial. A retrospective study of 798 consecutive biopsies was performed to determine whether disaccharidase activities varied by subject age, biopsy technique, and degree of villus atrophy. Lactase activity was inversely correlated with age in the absence or presence of villus atrophy; sucrase, maltase, and palatinase activities did not correlate with age. Biopsies obtained by capsule or endoscopy had similar disaccharidase activities. In subjects 24 months of age or younger, the degree of mucosal injury was inversely correlated with lactase activity. In subjects older than 24 months, the degree of mucosal injury was inversely correlated with maltase and, to a lesser extent, lactase activities. The data suggest that disaccharidase activities in mucosal biopsies, whether obtained by endoscopy or capsule, are diminished in the presence of mucosal injury and correlate inversely with the degree of injury.