Objectives:Chronic occult blood loss from the gastrointestinal tract is a recognized major cause of iron-deficiency anemia. After conventional investigation of the upper and lower parts of the gastrointestinal tract, the source of bleeding remains unidentified in ~10% of these patients. We evaluated the diagnostic yield of capsule endoscopy from patients enrolled in clinical studies due to persistent or recurrent iron-deficiency anemia. Methods: In this large cohort study, patients with obscure gastrointestinal bleeding were identified in a company-sponsored clinical study (Given Imaging, Ltd.) database which contains data from >50 clinical studies. Information on suitable patients was derived from 31 of them. Each subject swallowed an M2A^® Given Capsule containing a miniature video camera, batteries, a transmitter and an antenna. Recording time was ~8 h. The capsule was excreted naturally in the patient’s bowel movement, and the data it transmitted were retrieved and interpreted the next day. Results: 293 patients were studied (135 males, 46.1%, mean age 59.4 ± 16.8 years) whose mean number of bleeding episodes was 4.3 ± 5.5 and mean hemoglobin level was 9.8 ± 2.4 g/dl. The average number of diagnostic procedures per patient prior to the capsule endoscopy study was 5.59. Capsule endoscopy detected definitive findings in 213/293 patients (72%) and findings missed by other diagnostic procedures in 22/293 patients (8%). Neither capsule endoscopy nor the other diagnostic procedures yielded diagnoses in 58/293 patients (20%). Conclusions: Capsule endoscopy has a high diagnostic yield in evaluating patients with obscure gastrointestinal bleeding.

The purpose of this study was to examine the effect of age and selected indications for capsule endoscopy on small bowel transit times. Data on 67 clinical studies (790 subjects with different gastrointestinal pathologies [49.5% males; mean age, 51.9 +/- 18.33 years; range, 18-91 years] and 87 healthy volunteers) were retrieved from the company (Given Imaging, Ltd.)-sponsored database. All subjects swallowed the PillCam SB Capsule after a 12-hr fast. The capsule reached the cecum in all 877 participants. Indications for referral for capsule endoscopy were as follows: 372 obscure gastrointestinal bleeding, 96 suspected Crohn's disease, 65 celiac disease, 54 irritable bowel syndrome, and 116 familial adenomatous polyposis, intestinal lymphoma, or ulcerative colitis. One group consisted of patients <40 years old (n = 235), and the other patients 40 years old (n = 555). The younger group, volunteers, and Crohn's disease patients had significantly shorter small bowel transit times than the others (P < 0.001). Gastric emptying indirectly influenced capsule transit time.

Summary:We have initiated a long-term prospective study of sexual function using the Derogatis Interview for Sexual Functioning (DISF) for males and females. 8 This self-adminisPatients undergoing high-dose chemotherapy and bone marrow transplantation (BMT) may experience a vartered questionnaire has a number of advantages. It is widely used, easy to administer and well validated in cancer iety of abnormalities of psychological and physical function including sexual dysfunction. However, no study patients. 9 It evaluates fantasy, arousal, experience, orgasm and desire in addition to giving an overall score of sexual has prospectively evaluated whether there is an association between sexual dysfunction and BMT. In a prefunction. In our initial study, we evaluated 30 patients pre-BMT and found that sexual dysfunction was commonly vious study in which we analyzed the sexual function of 30 patients immediately before transplant, we found seen. 10 Since then the sample size has been increased to 50 and we have prospectively resurveyed these patients at 3 that nearly half of all patients had sexual dysfunction using the Derogatis Interview for Sexual Functioning months, and in some cases, 12 months post-BMT. We also attempted to correlate these results with possible demofor males and females. The findings of the pilot study led us to hypothesize that the incidence of sexual dysgraphic risk factors for sexual dysfunction, as well as with the medical complications of the transplant. function would not be significantly altered by BMT; we performed a prospective study designed to test this hypothesis. In this study a further 20 patients about to undergo BMT were surveyed, making a total of 50.Patients and methods Thirty-one of 38 survivors were reanalyzed 3-6 months after transplant. The major finding of the study is thatPatients and definitions the incidence of sexual dysfunction is unchanged 3 months after transplant (48 vs 36%, P = NS). The mean All patients between the ages of 16 and 65 years undergoing bone marrow transplantation between July 1994 and total score on the DISF was decreased by 7.5 points but this was also not significant. A preliminary analysis of November 1995 at Hahnemann University Hospital were approached to participate in a prospective study of sexual 16 patients surveyed at 12 months post-BMT suggests little change in sexual function between 3 and 12 months function. The sexual function of the first 30 patients pre-BMT has been reported in detail. 10 The majority of patients post-BMT. We conclude that in the first 12 months after high-dose chemotherapy and BMT the pretreatment received regimens containing busulfan and cyclophosphamide. Patients with breast cancer received cisplatinum and difficulties remain.

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