Economist Examines 'Snail-Fever' In China
The Economist examines schistosomiasis in China. The disease, which is also called snail-fever, is the "world"s second-most prevalent tropical disease after malaria, affecting 207 million people of whom 726,000 are Chinese, according to the most recent official figures, from 2004," the Economist reports.
Public Health
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More Effective Tools For Detection Of Colorectal Cancer Identified By New Research
said Ana Ignjatovic, BMBCh, endoscopy research fellow at the Wolfson Unit for Endoscopy at St. Mark"s Hospital. Both Dr. Ignjatovic and Brian P. Saunders, MD, director of the Wolfson Unit for Endoscopy, believe that the next steps should be to expand the study beyond an academic center to determine the level of training that would need to be provided before the procedure could be used on a wider scale. Dr. Ignjatovic will present these data on Tuesday, June 2 at 10:30 a.m. CDT in S406A, McCormick Place. Risk of Perforation During Colonoscopy: A Systematic Review and Meta-analysis (Abstract #210) Perforation rates for both diagnostic and therapeutic colonoscopies are quite low and reported rates are decreasing, according to the largest analysis to date of colonoscopy perforation rates. Using meta-analysis, a type of systematic review that includes formal statistical techniques to combine the results of previous research, investigators under the mentorship of Philip S. Schoenfeld, MD, at the University of Michigan sought to establish an accurate measure of colonoscopy perforation rates. According to previous research, reported rates of perforation in the literature range from as low as 0.01 percent (1 in 10,000) to as high as 1.1 percent (1 in 100). "Perforation is one of several potential complications of colonoscopy including cardiopulmonary events, hemorrhage and pain," said S. M. Abbas Fehmi, MD, MSc, clinical faculty at University of Pennsylvania School of Medicine. "Of these risks, perforation has been considered by some to be the most serious, so we wanted to determine the actual rate of perforation to help patients and their physicians make informed decisions. The good news is that we found the risk of perforation during colonoscopy is extremely low." Fehmi and his colleagues searched databases from 1950 through 2007 for all English language abstracts of prospective studies related to perforation rates. They also reviewed abstracts presented at all major national and international gastroenterology meetings from 2005 to 2007. Seventeen studies, consisting of 274,265 colonoscopies, met the inclusion criteria. Pooled perforation rate in therapeutic colonoscopies was found to be 0.066 percent or approximately 1 in 1500 and in diagnostic colonoscopies was found to be .017 percent or approximately 1 in 6000. Therapeutic colonoscopy, which is required to remove lesions if polyps are present, was associated with a higher risk of perforation. The analysis also identified a trend towards decreasing perforation rates for both therapeutic procedures and diagnostic procedures. Fehmi said that while colonoscopy is a safe procedure, there are some risks that need to be explored further. Studies should be done in the community and university setting and patients should be stratified by different risk factors and indications. Future prospective studies should also employ a systematic follow up (at day seven or 30) to ensure capture of all complications. These quoted rates of perforation can serve as a quality, performance, or outcome benchmark. Dr. Choksi presented these data on May 31. Aimee Frank American Gastroenterological AssociationPages: 1 [2]