Adequate cleansing is essential for reliable diagnostic and surgical colon procedures. Accuracy and safety depend on good preparation. Patient compliance is enhanced by simplicity and well‐tolerated methods. Several methods are available. Diet and cathartic regimens utilize clear liquids or diets designed to leave a minimal colonic residue. Laxatives, cathartics and enemas are employed. Gut lavage solutions are osmotically balanced electrolyte lavage products. Oral sodium phosphate solutions and tablets are available and are attractive because of good efficacy with a small volume of administration. For colonoscopy and colon surgery preparation, these methods have been proven safe and effective. For barium enema X‐ray, lavage requires an adjunctive agent such as bisacodyl to enhance barium coating. Overall, all regimens are well‐tolerated. This review discusses the development and clinical experience with various colon cleansing regimens.

In this study, the risk of recurrent deep venous thrombosis in young people was not related with the presence of FV G1691A, FII G20210A, MTHFR C677T or PAI-1 4G/5G polymorphisms.

Sirs, Varicella is typically a benign childhood disease caused by varicella zoster virus (VZV), though serious complications can arise [1,2]. Varicella has been commonly associated with stroke in children [3], but exceptional reports have described afflicted immunocompetent adults, repeatedly relating vasculitis with this condition [4][5][6][7][8].A 39-year-old right-handed male, smoker (10 cigarettes/day), developed varicella 2 weeks after his 4-year-old daughter showed the characteristic rash. Acute pain and pallor of the left lower limb and absent ipsilateral foot pulses suddenly emerged 1 week later, as well as left hemiplegia, left homonymous hemianopia and hemineglect. Emergent lower limb angiography ( Fig. 1a and b) showed one occlusive (left femoral artery) and two sub-occlusive thrombi (left common iliac and right femoral arteries); thromboembolectomy was carried out. Intravenous non-fractionated heparin, acyclovir and methylprednisolone (5-day course, followed by oral prednisone and tapering) were prescribed. Acyclovir and corticosteroids were employed because of suspected VZV-related vasculitis. Central retinal artery occlusion of the right eye, probably the first event according to the patient, was later perceived. Laboratory examinations revealed: increased leucocytes (16.87 · 10 9 /l), C-reactive protein (19.3 mg/l) and erythrocyte sedimentation rate (49 mm/h), low protein S (0.18 U/ml, normal range 0.60-1.40), positive anticardiolipin IgM and antibeta2-glycoprotein-I IgM (25.3 MPL and 45.5 SMU, respectively; normal <15), positive VZV-specific IgM and positive VDRL at 1:8 dilutions (TPHA negative). Other blood tests were normal, including folic acid, vitamin B12, homocysteine, thyroid function tests; microbial cultures; screening for HIV, HBV and HCV; immunological screening; other basic coagulation tests and inherited prothrombotic disorders screening. Cerebrospinal fluid examination disclosed 9 cells/ mm 3 , normal protein and glucose levels;negative VZV DNA, anti-VZV antibodies (IgM, IgG), VDRL, TPHA and cultures. Transesophageal echocardiography and ECG were normal. Carotid and transcranial ultrasound showed eccentric luminal stenosis (40%) of the proximal right internal carotid artery with hypoechoic material; on serial testing, gradual shrinkage (to 20% 20 days later) and distal progression were demonstratedfindings that cannot be attributed to an atherosclerotic plaque. Brain MRI (1.5 T) was conducted 1 week after admission, showing the lesions observed in Fig. 1c. On discharge the patient presented right eye blindness, left hemiparesis and hemianopia; 3 months later he walked autonomously using one crutch. All abnormal laboratory findings returned to normal and so remained. Warfarin was stopped 6 months later; his current medication consists of antiplatelet drug and statin.We believe that these data strongly suggest that the vascular events sustained by this patient were associated with VZV, and occurred in the setting of a transitory prothrombotic condition, which also finds support in the ...

No abstract

No abstract

Objective: To evaluate the association between the Factor V Leiden (FV R506Q) and prothrombin gene (FII G20210A) mutations and deep venous thrombosis (DVT) in young people. Methods: Blood samples were drawn from 199 subjects: 100 healthy controls and 99 unselected patients, with an objectively documented first episode of DVT under 40 years old. DNA analysis was performed using the polymerase chain reaction. Results: The mean age in the patient cohort was 27 years (range 16–40) and 68 (68.7%) were women. Patient prevalences were 20.6% and 10.1% for FV R506Q and FII G20210A, respectively. In the control group, carrier frequencies were 2% and 5%, respectively. We found an increased overall relative risk of DVT with statistical significance for FV R506Q carriers (OR: 12.8; 95% CI: 2.9–56.7; P < 0.001), but not for FII G20210A mutation (OR: 2.1; 95% CI: 0.7–6.5; P = 0.19). Conclusions: Our results suggest a possible increase in DVT risk for the young G20210A allele carriers, which can be more expressed in the presence of a circumstantial risk factor. There is extremely strong evidence that the Factor V Leiden mutation is an important risk factor in the development of a first episode of DVT in young people.

Objective: To evaluate the association between the 4G/5G polymorphism in the promoter of the plasminogen activator inhibitor-1 (PAI-1) gene and deep venous thrombosis (DVT) in young people. Methods: Prevalence of the 4G/5G polymorphism was investigated using DNA analysis in a population of 81 consecutive and unrelated patients with an objectively documented first episode of DVT under 40 years old and in a control group of 88 healthy subjects. Results: The frequency of genotypes among patients was 0.27 4G/4G, 0.49 4G/5G and 0.23 5G/5G, corresponding to a frequency of 0.52 for the 4G allele. In the control group the results were, respectively, 0.24, 0.44 and 0.32, corresponding to a frequency of 0.46 for the 4G allele. The odds ratio (OR) for homozygous 4G genotype was 1.5 (95% confidence interval: 0.7–3.6), which was not statistically significant ( P = 0.51). Conclusion: In this study, the 4G/5G polymorphism in the promoter of the PAI-1 gene, including the homozygous 4G genotype, was not associated with a significantly increased risk of DVT in young people.

No abstract