Significant Increase In Average Number Research Articles

S1098 Learning Curve of Transoral Incisionless Fundoplication: A Proficiency Study

Introduction: Transoral incisionless fundoplication (TIF) is a minimally invasive endoscopic procedure for treatment of gastroesophageal reflux disease. Performing TIF requires unique training to achieve proficiency. This study aims to evaluate the learning curve of performing TIF in relation to patient and procedure-specific characteristics. Methods: This is a retrospective study of consecutive TIF procedures performed by a single experienced gastroenterologist to assess the procedure learning curve. Historical and procedural characteristics were recorded, and the learning curve was estimated by cumulative sum of means (CUSUM) analysis. Proficiency was defined as reliably achieving a procedure length less than 45 minutes. Results: 77 consecutive TIF procedures (68 patients) were included. The average age of patients was 52.35 ± 15.74 years (32.4% male). The estimated learning plateaus for procedure time and number of fasteners were 41 minutes and 24 fasteners, respectively. Twelve procedures were required to reliably achieve a procedure length of 45 minutes or less. There was no significant correlation between the length of the TIF procedure and number of fasteners (p=0.091) or Hill classification (I vs II/III) (p=0.483). There was no relationship between the Hill classification (I vs. II/III) and number of fasteners (p=0.475). We observed a significant increase in average number of fasteners used over time from 18.5 ± 2.28 during the first quartile of procedures to 29.82 ± 4.61 in the last quartile (p=0.01). There was no relationship between procedure length, ASA score, number of fasteners, and hospital length of stay. Conclusion: Proficiency in performing TIF in less than 45 minutes can be achieved after independently performing 12 procedures.Figure 1.: Non-linear regression curves for proficiency of procedure duration and number of fasteners Table 1. - Baseline patient characteristics and procedural outcomes Patient summary characteristics: Gender (Female) 67.6% (n=46) Age [mean ± SD] 52.35 ± 15.74 Race White 79.41% (n=54) Non-Hispanic 67.65% (n=46) BMI [mean ± SD] 27.7 ± 5.1 ASA Score II 69.1% (n=47) III 29.4% (n=20) IV 1.5% (n=1) Prior history of Barrett’s ablation 4.4% (n=3) Prior esophageal surgical intervention Nissen Fundoplication 8.8% (n=6) POEM- Nissen Fundoplication 1.5% (n=1) POEM 2.9% (n=2) Indication for TIF GERD 83.82% (n=57) Chronic cough +/- GERD 16.17% (n=11) Hernia HILL grade (if available): 1 25% (n=14) 2 62.5% (n=35) 3 8.9% (n=5) 4 3.6% (n=1) Longitudinal length of hernia ≥ 2cm (available value; n=56) 26.78% (n=15) PH impedance or Bravo test (uninterpreTable; n=1, not performed due to presence of BE/esophagitis=5) Acid 82.26% (n=51) Non-acid 17.74% (n=11) Procedure characteristics: Total TIF procedures (n=77) Median procedure length(minutes) [min, max] 41 [26,91] Number of fasteners [mean ± SD] 23.1 ± 6.2 Number of fasteners original TIF per Quartiles [mean ± SD] First 18.5 ± 2.28 Second 21.53 ± 3.12 Third 24.71 ± 3.53 Forth 29.82 ± 4.61 Median Hospital LOS (days) [min, max] 1 [0,10]

DISTRIBUTION AND QUANTITATIVE CHANGES OF MAST CELLS IN GUINEA PIGS LUNG IN OVALBUMIN-INDUCED ALLERGIC INFLAMMATION

Background. One of the most important cells in local immunity in lung are mast cells. They are involved in both innate and adaptive immune responses to inhaled allergens. The question of distribution of these both cell types in guinea pig lung in case of experimental allergic inflammation in most aspects remains open. Objective. The aim of this research is to study the distribution and quantitative changes of mast cells in lung of guinea pigs in ovalbumin-induced allergic inflammation. Methods. the lungs of 48 male guinea pigs have been studied using histological, morphometric and statistical methods in cases of experimental ovalbumin-induced allergic inflammation. The total number of mucosa related must cells and perivascular mast cells in guinea pig lungs were counted. Results. It has been established that mucosa related mast cells are normally more abundant in guinea pigs lung than perivascular ones. Maximum increase in a number of mucosa related mast cells was revealed in the early period of allergic inflammation, as evidenced by maximum increase coefficient of 1.4 in the 1st experimental group, compare to the control (P*/**<0.05). However, maximum increase in number of perivascular mast cells in 5 times was found during the late period of allergic inflammation in the 4th experimental group (P*/**<0.05). Conclusion. Experimental sensitization and challenge with ovalbumin leads to statistically significant increase in average number of both types of mast cells but predominantly the latter ones. It has been proved that cells dynamics is multidirectional.

Medical Marijuana Effects in Movement Disorders, Focus on Huntington Disease; A Literature Review.

We aimed to comprehensively evaluate the effects of medical marijuana on symptoms that are relevant to movement disorders with a focus on Huntington disease (HD). A systematic review by literature search through PubMed and EBSCO electronic databases was conducted for relevant studies reported after 2002 on the effects of medical marijuana or cannabis use on tremor, spasm, spasticity, chorea, sleep quality and HD-specific rating scales. Study selection, quality assessment and data extraction was performed by three reviewers. Outcome measures were changes in psychomotor, and sleep related symptoms. The methodological quality of the included studies was evaluated.Results:A total of 22 studies were reviewed.There was strong evidence for significantimprovement in the neurologic symptoms of spasms, tremors, spasticity, chorea, and quality of sleep following treatment with medical marijuana. Analysis of specific motor symptoms revealed significant improvement after treatment in tremors and rigidity. Furthermore, all pretreatment and post-treatment measures indicated a significant increase in average number of hours slept. Larger scale studies are warranted to test the benefits of medical marijuana in HD patients. In the meanwhile, clinicians may consider prescribing medical marijuana as part of their strategy for better symptomatic treatment of patients with HD.

Evaluation of Phytotoxicity of Sulfantrazone 48% F to Sugarcane Saccharum officinarum L.

A field experiment was conducted at the Indian Institute of Sugarcane Research, Luchnow, under subtropical Indian conditions during the season 2012-2013 to study the evaluation of phytotoxicity of sulfantrazone 48% f to sugarcane variety CoSe 92423. The experimental design was Randomized Complete Block Design (RCBD) with four replications. The treatments used in the experiment are sulfentrazone PPI 720 g a.i.ha-1, sulfentrazone PPI 1440 g a.i.ha-1, sulfentrazone Pre-em: 3 DAP 720 g a.i.ha-1, sulfentrazone Pre-em: 3 DAP 1440 g a.i.ha-1 and untreated control(weedy). The results showed that sulfentrazone PPI 1440 g ai.ha-1 registered the highest increase of germination (56.9 %) that didn’t differ significantly from other treatments. The dry matter accumulation in weeds was the lowest (7.2, 10.6 and 22.8 g.m-²) in sulfentrazone PPI 1440 a.i.ha-1 treatment achieved highest inhibition proportion of dry matter (90.2, 88.9 and 83.5 % ) at the 60, 90 and 120 DAP respectively. Phytotoxicity was not significantly affected by use of sulfentrazone herbicide. a significant increase in average number of canes by using sulfentrazone PPI 1440 g a.i.ha-1 led to even the highest increase in this attribute at the 90,120,150, 210 and 300 DAP. The use of sulfentrazone PPI 1440 g a.i.ha-1 registered the highest cane yield (84.1 t.ha-1) that was significantly higher to the tune of 44.94 % over control. Addition of sulfentrazone treatments significantly affected sugar yield. Sulfentrazone PPI 1440 g a.i.ha-1 and sulfentrazone Pre-eme 1440 g a.i.ha-1caused highest increase in this character which reached to 13.850 and 13.500 t.ha-1respectively.

Effect of Babylon weeping willow (Salix babylonicaL.) extracts on rooting of stem cuttings of olive (Olea europaeaL.) ‘Nabali’

Four experiments namely: soaking stem cuttings of 'Nabali' olive in willow water shoot extract (SE), leaf extract (LE), wood extract (WE), and bark extract (BE) plus dipping in 4000 ppm K-IBA solution were performed to test the effect of the extracts on rooting the cuttings. Irrespective of K-IBA dipping, the results showed that soaking the cuttings in BE for 48 h gave a significant increase in rooting percentage (46.9%) while soaking them in SE or LE or WE was ineffective. Soaking the cuttings in SE for 4 h or BE for 12 h significantly increased callusing percentages (61.3 and 55.6%,) while soaking them in LE or WE was ineffective. Soaking the cuttings in SE or LE or BE for 2, 24, 48 h, respectively, caused a significant increase in average number of roots per rooted cutting (3.9, 3.6, 4.4) while soaking them in WE was not. Irrespective of soaking the cuttings in the four willow extracts, dipping the cuttings in K-IBA 4000 ppm gave significantly higher rooting percentages (45.9, 44.3, 44.5, and 46.0%). Callusing percentage was significantly reduced in SE (40.5%) as compared to the control (55.5%) while in LE, WE, and BE was not. Average number of roots per rooted cutting was significantly increased in the four experiments.

Tolerance and Efficacy of a Probiotic Supplement Delivered in Capsule Form

Probiotic supplementation may promote a healthy microbiome, alleviate diarrhea and constipation, and improve some metabolic parameters. Bacillus subtilis, used in fermentation of some foods, may also be tolerated and effective in a concentrated supplement form. Forty healthy male and female adults (23 ± 3.9 years of age) were randomly assigned, in a double‐blind placebo‐controlled trial, to probiotic (approximately 1.9 x 109 CFU/capsule) or placebo groups for an average of 20 days. Subjects were instructed to maintain their usual diet and activity levels over the course of the study. Fecal and fasted serum samples were collected before and after capsule consumption. Dietary and daily bowel movement (BM) frequency and consistency records were reported by subjects. Fecal DNA was subject to polymerase chain reaction (PCR) and real‐time PCR (qPCR) for microbial detection and quantification. Metabolic, lipid, and C reactive protein levels remained within normal ranges from pre‐ to post‐ capsule consumption, however serum glucose was significantly reduced in the probiotic group (91.0 to 85.9 mg/dL, α 蠄 0.05; P = 0.012). A significant increase in average number of BMs reported per day was seen in the placebo group (α 蠄 0.05; P = 0.015). No significant differences in fecal microbe content were seen in qPCR analysis, though some trends were indicated with qPCR and fecal plate count analyses. Daily consumption of B. subtilis was well tolerated and may be effective as a supplement for those with glucose intolerance and diabetes, and promote regularity of bowel movements. Limitations of the study included lack of dietary and alcohol intake control and an inadequate number of fecal subsamples for follow‐up analyses. This study was funded by Deerland Enzymes Inc.

Pilot Study of the Feasibility and Effectiveness of a Natural Laxative Mixture

We sought to determine the effect of a natural laxative mixture compared with daily prescribed laxatives on bowel movement frequency in elderly long-term care residents. Secondary endpoints included ease of administration and costs of the natural laxative. A randomized controlled trial comparing the effect of the Beverley-Travis natural laxative mixture to prescribed laxatives was conducted over an 8-week period. Subjects were randomized to treatment and control groups; control subjects continued on regularly prescribed laxatives, and treatment group subjects discontinued prescribed laxatives and received 2 tablespoons of the natural laxative mixture twice a day for the remaining 4-week period. Bowel movement frequency and consistency were collected, and ease of natural laxative administration as well as costs associated with use of the natural or prescribed laxatives were calculated. The study included 45 residents, with 34 completing the 8-week study period (16 treatment group subjects and 18 control subjects). Treatment group subjects had a significant increase in average number of bowel movements from 15.5 to 22.2 (P = .007) following initiation of the natural laxative, and no difference in bowel movement frequency was observed among control subjects (P = NS). The natural laxative mixture was rated as "easy" or "very easy" to administer by 90%-92% of nurses, and cost savings of $103.04 was estimated. The Beverley-Travis natural laxative mixture, given at a dosage of 2 tablespoons twice daily, is easy to use, cost-effective, and more effective than daily prescribed laxatives at producing normal bowel movements.

Effect of intravaginal electrical stimulation on pelvic floor muscle strength

The aim of this study was to evaluate the effect of intravaginal electrical stimulation (IES) on pelvic floor muscle (PFM) strength in patients with mixed urinary incontinence (MUI). Between January 2001 and February 2002, 40 MUI women (mean age: 48 years) were studied. Urge incontinence was the predominant symptom; 92.5% also presented mild stress urinary incontinence (SUI). Selection criteria were clinical history and urodynamics. Pre-treatment urodynamic study showed no statistical differences between the groups. Ten percent of the women in each group had involuntary detrusor contractions. Patients were randomly distributed, in a double-blind study, into two groups. Group G1 (n=20), effective IES, and group G2 (n=20), sham IES, with follow-up at 1 month. The following parameters were studied: (1) clinical questionnaire, (2) examiner's evaluation of perineal muscle strength, (3) objective evaluation of perineal muscle by perineometry, (4) vaginal weight test, and (5) urodynamic study. The IES protocol consisted of three 20-min sessions per week over a 7-week period using a Dualpex Uro 996 at 4 Hz. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence, present in all patients before treatment, was reduced to 15% in G1 and 31.5% in G2 post-treatment. The subjective evaluation of PFM strength demonstrated a significant improvement in G1. Objective evaluation of PFM force by perineometer showed a significant improvement in maximum peak contraction post-treatment in both groups. In the vaginal weight test, there was a significant increase in average number of cone retentions post-treatment in both groups. With regard to satisfaction level, after treatment, 80% of the patients in G1 and 65% of the patients in G2 were satisfied. There was no statistically significant difference between the groups. There was a significant improvement in PFM strength from both effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy in treating MUI.

Validation of Online Walking Logs for Middle Aged and Older Adults

2064 Findings from recently published studies support the use of the Internet for delivering physical activity interventions, but to date few studies have published results validating online, self-report physical activity measures. PURPOSE: To compare the results of self-report walking logs completed online or on paper with data from corresponding 1-mile walk tests and data collected from accelerometers. METHODS: An 8-week randomized controlled trial was conducted with a sample of 94 (n = 21 male, n = 73 female) healthy, low active, computer users (Mean age = 54.4) randomized to either the Internet or the standard care condition. The Internet condition followed a homebased walking program that was delivered online with weekly email reminders and the standard care condition followed the same 8-week home-based walking program delivered via the postal service with weekly telephone reminders. A sub-sample of participants (n = 14) who lived close to the research facility completed both a Rockport 1 mile walk test and wore accelerometers both at the beginning and the end of the study. The main objective of this study was to compare the results of these 2 physical activity measures and the weekly walking logs completed during the intervention. RESULTS: A repeated measures multivariate analyses of variance indicated that there were no differences across groups in any of the measures. There was a significant decrease in Rockport times (17.3 versus 16.4 mins, p = .007) and a significant increase in average number of self-reported minutes walked per week (60.8 versus 154.1 mins, p < .001) across groups. Although the increase in the mean accelerometer score was not significant (p > .05), there was a significant correlation between changes in accelerometer scores and changes in self-report minutes spent walking (r = .54, p = .018). CONCLUSIONS: These results provide preliminary support validating both online and paper versions of self-report walking logs from a home-based walking program. This study was conducted while Gerald J. Jerome was at the University of Illinois. Supported by American College of Sports Medicine Foundation Research Grant and The Weiss Research Endowment, American College of Sports Medicine.