Quality Indicators for Colonoscopy Procedures: A Prospective Multicentre Method for Endoscopy Units

BACKGROUND AND AIMS: Healthcare professionals are required to conduct quality control of endoscopy procedures, and yet there is no standardised method for assessing quality. The topic of the present study was to validate the applicability of the procedure in daily practice, giving physicians the ability to define areas for continuous quality improvement. METHODS: In ten endoscopy units in France, 200 patients per centre undergoing colonoscopy were enrolled in the study. An evaluation was carried out based on a prospectively developed checklist of 10 quality-control indicators including five dependent upon and five independent of the colonoscopy procedure. RESULTS: Of the 2000 procedures, 30% were done at general hospitals, 20% at university hospitals, and 50% in private practices. The colonoscopies were carried out for a valid indication for 95.9% (range 92.5-100). Colon preparation was insufficient in 3.7% (range 1-10.5). Colonoscopies were successful in 95.3% (range 81-99). Adenoma detection rate was 0.31 (range 0.17-0.45) in successful colonoscopies. CONCLUSION: This tool for evaluating the quality of colonoscopy procedures in healthcare units is based on standard endoscopy and patient criteria. It is an easy and feasible procedure giving the ability to detect suboptimal practice and differences between endoscopy-units. It will enable individual units to assess the quality of their colonoscopy techniques

Morphological characterisation of cultured and freshly separated cyanobionts (Nostocales, Cyanophyta) from Azolla species

A comparative examination of the morphological attributes of freshly separated and cultured cyanobionts of six species of Azolla, namely A. microphylla, A. filiculoides, A. rubra, A. caroliniana, A. mexicana and A. pinnata, was carried out. Distinct variation with respect to colour and nature of filaments, size and frequency of heterocysts was observed when counterparts of cultured and freshly separated cyanobionts from each species of Azolla were compared. The cyanobionts from A. pinnata showed distinctly larger cells compared with the cyanobionts from other Azolla species, whereas the cyanobiont of A. mexicana resembled Nostoc in exhibiting coiled filaments. The other cyanobionts exhibited mostly straight filaments similar to Anabaena. This investigation brings out clearly the morphological variations existing among the cyanobionts belonging to the different species of Azolla and the transitional changes under in vitro conditions, need to characterise the cyanobionts at inter- and intraspecific level using molecular tools in the future for a more reliable classification system of the cyanobionts associated with Azolla