The Effect of Music on Anxiety of the Endoscopic Client in a Private Hospital in Ho Chi Minh City Vietnam

Gastrointestinal tract cancer is one of the fifth most common cancers in Vietnam and has a high mortality rate in Vietnamese people based on the Centers for Disease Control and Prevention (2018) global cancer statistics. One-third of adults aged 50 or older, the age group at greatest risk of developing colorectal cancer, have not been screened because endoscopy is considered a stressful procedure. The endoscopic patient sometimes refuses to have the procedure. Therefore, using music to ease the anxiety of endoscopic clients has been examined in various studies but the results have been inconclusive. The aim of this study was to examine the effect of music therapy on the anxiety of Vietnamese endoscopic clients in a district private hospital. The quasi-experimental research evaluated changes in vital signs, pain scores, and anxiety levels before and after the endoscopic procedure among participants who listened to music and those who did not. Forty patients participated: 18 who listened to music before and during the procedure and 22 who served as the control group. The Statistical Package for the Social Science (SPSS) version 20 was used to analyze data. There was a significant difference among the anxiety levels of those who chose to listen to music and those who did not listen at p \u3c .000. Those who listened to music appeared to have lower anxiety scores pre, peri, and post procedure. No significant differences in perceived pain were found between groups. In conclusion, while music did not result in shortened procedure times or doses of sedative medications utilized, it did reduce blood pressure and heart rate among patients undergoing endoscopy. Additionally, most of the endoscopic clients were willing to repeat an endoscopic procedure in the future. Limitations of this study included a small sample size and since only one hospital was utilized, data might not be representative of the whole endoscopic patient population in Vietnam. Future studies should expand to include more patients at multiple facilities

Focal Spot, Winter 2008/2009

https://digitalcommons.wustl.edu/focal_spot_archives/1110/thumbnail.jp

Quality assurance of training in diagnostic and therapeutic gastrointestinal endoscopy

Previous evidence has shown that standards of performance in gastrointestinal endoscopy are variable and that there are disparities in training outcomes. Many changes have been made recently to both training and assessment of endoscopy in the UK. However, no prospective methods of evaluating their outcome have been put in place. The aims of this research were to evaluate current and new training processes and assessments in order to quality assure the outcomes and improve the training process. Two audits were undertaken demonstrating improvements in colonoscopy training over 5 years within a single region and in trainee perceptions of their training nationally. Two studies were done investigating a novel computer colonoscopy simulator for assessment of colonoscopic skills, demonstrating excellent construct validity. A multi-centre randomised controlled trial evaluated the use of this simulator in novice training, which was shown to be equivalent to standard bed-side training with a high degree of skills transfer to real-life colonoscopy. Assessment tools for therapeutic endoscopic procedures were developed, validated and used to quality assure a course in therapeutic endoscopy. This course resulted in significant improvements in practical skills for three of the four therapeutic procedures following training. Web-based training and assessment modules for lesion recognition at capsule endoscopy were developed, validated and piloted. This demonstrated the effectiveness of using new training methodologies for skills improvement in this area. A training course for radiographers in virtual colonoscopy was developed and the training evaluated. This demonstrated competence in practical performance and improvements in knowledge and interpretative skill. Finally, two qualitative studies on non-technical skills in endoscopy were undertaken in order to widen the assessment domains from purely knowledge and skill. An interview study provided the basis for development of a nontechnical skills taxonomy and a video-analysis study resulted in production of a marker system for professional behaviour within gastrointestinal endoscopy

Outlook Magazine, Autumn 2012

https://digitalcommons.wustl.edu/outlook/1187/thumbnail.jp

Genetic and Environmental Risk Factors Associated with Colon Cancer

Colorectal cancer represents one of the most common causes of mortality in the world. A major number of populations develop an adenoma by the age of 40s. Over the past years, it has become clear that genetic factors are of crucial importance in colorectal tumorigenesis. Familial adenomatous polyposis (FAP) is responsible of developing numerous colorectal cancers cases by causing mutations in the germline in adenomatous polyposis coli (APC) genes. Colon cancer is considered the second most frequent cause of death in most of the Western countries. Colonic cancer is common in women and rectal in men. It arise in adenomatous polyps and is associated with both genetic and environmental factors that affect the development of the polyp. The aim of the present study was to analyze a set of environmental and genetic variables that can help in predicting the factors affect the formation of colorectal cancer. Additionally, the aim of this study was to define the epidemiology of colorectal cancer in AI-Ain city in the United Arab Emirates and compare it with regional and international literatures. Also, to examine the pattern of survival in relation to the initial diagnostic stage and histopathologic grades. The study focus on the comparison between patients with colorectal disease and non-colorectal disease on the level of environmental by studying their life style and on the level of genetics by screening part of the DNA (APC gene) for any mutation that cause colorectal cancer. The study was conducted in the Preventive Medicine Department, Al-Ain Medical District in AI-Ain and Tawam Hospitals. The study included 65 patients with colorectal disease gone for endoscopy, and 65 control patients with non-colorectal disease, and 7 patients diagnosed with colorectal cancer during 2000 year. The retrospective study included all colorectal cancer patients diagnosed or referred to these two hospitals between January 1985 and December 1998. The retrospective study consisted of 114 patients with colorectal carcinoma admitted to both hospitals. Although this study is not intended for generalization of the DNA mutation to the whole UAE population, but without any doubt this study would be a representative sample of concurrent screening of DNA mutation in the community. The first part of the study was epidemiological data presenting the life style of the patients through out the questionnaire to compare between the two groups in their nutritional habitat, while the second part of the study focussing on detecting the DNA mutations in the germline of the APC gene to know the cause of colon cancer formation whether environment or genetical. In this study three systems of primers are used depending on the frequencies of mutations observed in the APC gene, the set of primers designed for system 1 amplified 91 bp flanking codon 1309 with incidence of 17% Familial Adenomatous Polyposis families mutation in this region of DNA. System 2 amplifies DNA fragment of APC gene flanking codon 1061 with incidence of approximately 8% mutation, while system 3 amplify flanking codon 1546 for mutation approximately 1.1 % Familial Adenomatous Polyposis family member. During the last twelve years a total 114 patients with colorectal cancer were diagnosed and referred to Tawam and AI-Ain hospitals in AI-Ain City, Abu Dhabi Emirate, in UAE. Mean annual incidence was 12 patients / year. The overall incidence is 6.6 / 100,000 patients. There were 77 males (67.5%) and 37 females (32.5%), and total of national and Omani patients were 44 (38.6%) and non-UAE national were 70 (61.4%). The mean age at the time of diagnosis is 46.6±11.8 years and with the median age of 47 years. The age of highest occurrence was between 41-50 years and accounted for 34.2%, while the lowest accounted for 7.9 % of the patients were below the age of 30 years. The main presenting symptoms were abdominal pain (29.1%), and change of bowel habits (15.4%) while the predominant sign was rectal bleeding (17.2%). The mean overall survival time was 30.89 ± 11.72 months with a range of 6 and 120 months. The mean survival time was significantly shorter for patient aged 40 years or less (p The predictor was significant as shown by the log rank test (p The study showed that the highest occurrence of colorectal cancer is about 45-60 years in the study population. The most common presenting symptoms was abdominal pain followed by abdominal bleeding. The rectum and sigmoid were the most common sites of tumor and our results are consistent with studies from UK and USA. Finally, the most of the lesions were seen in Duke B and C

Healthy You

https://scholarlyworks.lvhn.org/healthy-you/1091/thumbnail.jp

216 Jewish Hospital of St. Louis

https://digitalcommons.wustl.edu/bjc_216/1181/thumbnail.jp

Reevaluating fecal microbiota transplantation for recurrent clostridium difficile infection

Clostridium difficile infection (CDI) is a disease associated with the wide-spread use of antibiotics and causes 450,000 infections and almost 30,000 deaths in the United States annually. Recurrence is a major problem, with approximately 1/3rd of patients relapsing after antibiotic treatment for CDI. Fecal Microbiota Transplantation (FMT) has emerged as a novel therapy for recurrent CDI, but the majority of the literature to date is made up of uncontrolled case series, so FMT’s true efficacy compared with standard antibiotic regimens remains unknown. Only a few randomized control trials (RCTs) have been published, and these have studied small numbers of patients and exhibited marked methodological heterogeneity. As such, there is uncertainty about the appropriate indications for FMT with respect to recurrent CDI, as well as the best methodology for the procedure, which has been carried our using various fecal preparations and modes of delivery. In particular, questions remain about if FMT should be recommended for patients with a first CDI recurrence, and if minimally invasive methods of performing FMT such as administration of enteric coated capsules are more efficacious than standard antibiotic treatments. We propose a double blind, placebo controlled, RCT that will be run as two parallel RCTs, where Trial 1 will enroll patients experiencing a first CDI recurrence, and Trial 2 will enroll patients experiencing a second or later CDI recurrence. The treatment arms in each trial will receive FMT in the form of orally administered frozen capsules, while the control arms will receive standard antibiotic treatments based on the number of recurrences they have experienced. If shown to be efficacious in a large RCT, oral capsulized FMT alone as treatment for recurrent CDI has the potential to increase access to FMT, decrease unnecessary antibiotic use, and substantially reduce morbidity and mortality attributable to CDI