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Tursi A.,Bt Inc.
Expert Review of Gastroenterology and Hepatology | Year: 2015

Acute diverticulitis, defined as acute inflammation of a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in the medical treatments offered to patients in recent years. Factors predisposing individuals to the development of acute diverticulitis include obesity, smoking, lack of physical activity and medication use, such as NSAIDs. Although widely used, there is limited evidence on the efficacy of individual antibiotic regimens and antibiotic treatment may not be required in all patients. Mesalazine seems to be the only effective treatment for the primary prevention of acute diverticulitis. Finally, evidence of effective measures for the prevention of recurrence is lacking. Furthermore, high-quality randomized controlled trials are required for medical treatments in patients with acute diverticulitis, if management is to be evidence based. © 2015 Informa UK, Ltd.

Holmes N.,Bt Inc.
Journal of perioperative practice | Year: 2011

Aspiration pneumonitis (Mendelson's syndrome) is universally accepted as a complication of general anaesthesia. According to Ellis et al (2007) death from aspiration was first described by Simpson in 1848, and it was not until 1946 that Mendelson identified acid aspiration in a significant number of obstetric patients undergoing facemask anaesthesia. The advent of techniques to secure the airway, through the use of airway adjuncts has gone some way to reduce the likely incidence of aspiration in today's perioperative arena. The positive outcome for patients is corroborated by Neilipovitz & Crosby (2007) who report aspiration as a rare complication with an overall incidence of 1:2,000-3,000. As Ewart (2007) highlights, Mendelson's syndrome is due to pharmacological effects at a molecular level which occur in the airway tissues and are caused by the use of induction and neuromuscular blocking agents. The resultant loss of consciousness and consequent diminished protective airway reflexes ultimately places the patient at risk until their airway is secured. Preventative measures to protect the lung from contamination with gastric contents, for example preoperative fasting, are therefore instigated prior to securing the airway.

Tursi A.,Bt Inc.
Journal of gastrointestinal and liver diseases : JGLD | Year: 2011

Tumour necrosis factor-α (TNF-α) expression may be increased in segmental colitis associated with diverticulosis (SCAD). Our aim was to assess TNF-α expression in SCAD in relationship to the treatment. 10 patients affected by severe (type B and D) SCAD were studied (6 males, 4 females, mean age 60.54 years, range 43-85 years). All patients were treated with beclomethasone dipropionate 10 mg/day plus a probiotic preparation VSL#3 for 8 weeks. At that time, clinical, endoscopic and histological reassessment was performed. Controls were 5 patients with active ulcerative colitis (UC). After treatment, all SCAD B and no SCAD D patients were in remission. The TNF-α expression dropped from 42.7% (+/-7.58) to 15.7% (+/-2.6) in SCAD B patients (p=0.001), and from 40% (+/-5.9) to 28.6% (+/-5.3) in SCAD D patients (p=0.005). In UC patients, the TNF-α expression dropped from 45.5% (+/-5.09) to 22.5% (+/-2.5) (p=0.001). Neither SCAD B nor SCAD D patients showed a significant difference in TNF-α expression compared to UC after treatment. Finally, TNF-α was significantly overexpressed in SCAD D than in SCAD B at the end of treatment (p=0.048). TNF-α expression in SCAD down regulates after treatment, and seems to be related to the clinical response to therapy. This behaviour, similar to that of Inflammatory Bowel Diseases (IBD), confirms that this disease should be considered as a subtype of IBD.

Tursi A.,Bt Inc.
Journal of Gastrointestinal and Liver Diseases | Year: 2015

Diverticulosis of the colon is frequently found on routine colonoscopy, and the incidence of diverticular disease and its complications appears to be increasing. The role of colonoscopy in managing this disease is still controversial. Colonoscopy plays a key role in managing diverticular bleeding. Several techniques have been effectively used in this field, but band ligation seems to be the best in preventing rebleeding. Colonoscopy is also effective in posing a correct differential diagnosis with other forms of chronic colitis involving colon harbouring diverticula (in particular with Crohn᾿s disease or Segmental Colitis Associated with Diverticulosis). The role of colonoscopy to confirm diagnosis of uncomplicated diverticulitis is still under debate, since the risk of advanced colonic neoplasia in patients admitted for acute uncomplicated diverticulitis is not increased as compared to the average-risk population. On the contrary, colonoscopy is mandatory if patients complain of persistent symptoms or after resolution of an episode of complicated diverticulitis. Finally, a recent endoscopic classification, called Diverticular Inflammation and Complications Assessment (DICA), has been developed and validated. This classification seems to be a promising tool for predicting the outcome of the colon harboring diverticula, but further, prospective studies have to confirm its predictive role on the outcome of the disease. © 2015, Romanian Society of Gastroenterology. All rights reserved.

Bt Inc. | Date: 2013-08-21

A buttocks intramuscular injection training model is provided. The buttocks intramuscular injection training model includes a hip model having a similar shape to a human hip; injection modules inserted into both sides of the hip model and each being configured to comprise electrode layers to detect a needle and a muscle layer into which injection liquid is injected; a controller connected to the electrode layers to detect a location of the needle; and an input and output device wired or wireless connected to the controller for bidirectional communication with the controller and configured to visibly output the location of the needle.

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