Hidden constipation presenting as diarrhea

Introduction: Diarrhea and constipation are two of the most common gastrointestinal symptoms presenting in both inpatient and outpatient settings. Diarrhea presents as loose, watery stool often with increased frequency while constipation often presents as hard stool, decreased frequency, and increased straining. In a subset of patients that suffer from constipation, liquid stool from more proximal colonic segments may bypass impacted feces and result in diarrhea, thus creating a confusing clinical picture and potentially misleading treatment plan. Objectives: Our objective is to redefine IBSD with a new subset of patients with IBSD who have hidden constipation. This study could help open up new pathways for therapy and greatly increase the quality of life of many patients. In our proposed study, we hope to look further into the relationship between patients suffering from constipation and its subsequent presentation as diarrhea. Methods: In this retrospective study we plan to radiographically analyze the stool burden of patients presenting with non-infectious diarrhea. We aim to assess the frequency of hidden constipation in patients presenting with diarrhea in the office of GI Consultants. The date ranges from January 2017 to present. Hidden constipation was assessed based on obstruction series or CT imaging. After ruling out other etiologies of diarrhea, such as bile acid associated diarrhea (BAD) or colitis, and, depending on the response, other workups, such as obstruction series and colonoscopies, were analyzed. Critical to our study will be the ruling out of any other potential cause of diarrhea, such as medications and previously mentioned infection. Once other causes are ruled out, focus can be given to the obstruction series for signs of constipation. Evidence of constipation on plain abdominal radiograph will show dilated loops of bowel with fecal material retained in areas of the large intestine. By documenting the areas of stool burden as seen on the obstruction study as ascending, transverse, or descending colon, we will begin to understand the prevalence and presentation of hidden constipation that presents paradoxically as diarrhea. Results: Of the 51 patients presenting with non-infectious, non-bloody diarrhea, 19.61% (n=10), presented with hidden constipation. Other significant presentations were bile acid diarrhea (19.61%), Irritable Bowel Syndrome (9.80%), and colitis (9.80%). 21.57% were unknown or lost to follow-up (n=11). Of the patients that did receive an obstruction series (n=12), 10 patients showed abnormal stool burden. Conclusion: This is a small retrospective study focusing on patients presenting to an outpatient setting with non-infectious, non-bloody diarrhea. Preliminary data has shown that with proper clinical suspicion, an obstruction series may be effective in showing hidden constipation in the setting of diarrhea. Further research may be necessary to show if laxative treatment of hidden constipation will be efficacious in treatment of hidden constipation associated diarrhea

The Ursinus Weekly, April 9, 1962

Junior class goes Parisian for Sunnybrook event Friday • Wurster elected YMCA president • Dr. Helfferich elected as UCC educators treasurer • Coeds tap Taney, Hartzell, Andrews for prexy posts • Pre-medicals hear Hahneman\u27s Bondi on chemotherapy • Sophomores slate weekend wingding • Thousands visit science fair at Ursinus College • Forum to present Sokoloffs in piano recital Wednesday • Pi Nu will sponsor music month here • Weekly banquet is Swint\u27s swansong • Moll announces MSGA now accepting petitions for 1962 membership • Editorial: A matter of policy; Is it worth it, men? • Letters to the editor • Next war praised; Bravo for Mackey • Meistersinger reports progress of New England tour via phone call • Conservative coed goes Dixie-way • Fighting Shaner leads Siebmen in sloppy 11-7 victory over Dickinson • Cindermen drop practice meet to Lehighers, 64 to 54 • Intramural corner • Dryfoos named outstanding player by coaches of MAC college division • Snyder places second in chess tournament • Greek gleanings • Miss Pennsylvania betroths UC grad • Final student concert spots Prokofieff work • Graduate grantshttps://digitalcommons.ursinus.edu/weekly/1316/thumbnail.jp

The Grizzly, April 18, 1986

The Bomb is Dropped; Policy Could Can Kegs • Admissions Video to Draw High School Seniors • CAB Spring Weekend Twists Around the Corner! • Administration\u27s Letter: Clearing Up the Cloudy Water • Get Your Ruby • Proposed Alcohol Regulations • Political Science\u27s Fitzpatrick to Focus on Constitution • Richter Joins Pavarotti • Greek Week Results • College Republicans Meet in Harrisburg • Perreten in Select Group to Interpret Humanities • Novack to Study Technology\u27s Effects on French Life • Lift-A-Thon: Pressing Weights for Progress • Women\u27s LAX Takes Two • Linksters Drive to 7-1 Record • Men\u27s LAX Strong at 5-2 • Rowson a Threat for Gold in Five Events • A Sterling Suggestion! Brown to be Tattooed • O\u27Toole Hurdles School Record • Men\u27s Tennis • Bears Battle Back • Hadler\u27s Medical Serieshttps://digitalcommons.ursinus.edu/grizzlynews/1988/thumbnail.jp

The Grizzly, May 2, 1986

Student Health Center • Musser Renovation Hatches U.C. Experiment in International Living • Maintenance Men Injured in Electrical Accident • Letters: Toilet Paper Article Belongs in the Toilet, not the Paper; Theatres Filthy • Schultz and Fletcher Retire After Long Ursinus Careers • Farewell Seniors • The Salinger Myth • Women\u27s Lacrosse Awaits NCAA Bid • Cornbone\u27s Curtain Call • U.C. Hosts MAC\u27s • Men\u27s Lax Ends at .500 • Ursinus Athletic Complex Reigns Supreme in Division III • Profile: Abe Rowson • Goodwin: A Bright Light in the Future of Ursinus Basketball • Costs and Past Vandalism Thwart U.C.\u27s Hosting Big Rock Bands • Briefs: Bear Pit; Happy Hour; Evening School; Radio; Education; Randolphhttps://digitalcommons.ursinus.edu/grizzlynews/1165/thumbnail.jp

An Early and Comprehensive Millimetre and Centimetre Wave and X-ray Study of SN 2011dh: a Non-Equipartition Blast Wave Expanding into a Massive Stellar Wind

Only a handful of supernovae (SNe) have been studied in multiwavelengths from the radio to X-rays, starting a few days after the explosion. The early detection and classification of the nearby Type IIb SN 2011dh/PTF 11eon in M51 provides a unique opportunity to conduct such observations. We present detailed data obtained at one of the youngest phase ever of a core-collapse SN (days 3–12 after the explosion) in the radio, millimetre and X-rays; when combined with optical data, this allows us to explore the early evolution of the SN blast wave and its surroundings. Our analysis shows that the expanding SN shock wave does not exhibit equipartition (ϵe/ϵB ∼ 1000), and is expanding into circumstellar material that is consistent with a density profile falling like R−2. Within modelling uncertainties we find an average velocity of the fast parts of the ejecta of 15 000 ± 1800 km s−1, contrary to previous analysis. This velocity places SN 2011dh in an intermediate blast wave regime between the previously defined compact and extended SN Type IIb subtypes. Our results highlight the importance of early (∼1 d) high-frequency observations of future events. Moreover, we show the importance of combined radio/X-ray observations for determining the microphysics ratio ϵe/ϵB

Radiation Test Results for a MEMS Microshutter Operating at 60 K

The James Webb Space Telescope (JWST), the successor to the Hubble Space Telescope, is due to be launched in 2013 with the goal of searching the very distant Universe for stars that formed shortly after the Big Bang. Because this occurred so far back in time, the available light is strongly red-shifted, requiring the use of detectors sensitive to the infrared portion of the electromagnetic spectrum. HgCdTe infrared focal plane arrays, cooled to below 30 K to minimize noise, will be used to detect the faint signals. One of the instruments on JWST is the Near Infrared Spectrometer (NIRSPEC) designed to measure the infrared spectra of up to 100 separate galaxies simultaneously. A key component in NIRSPEC is a Micro-Electromechanical System (MEMS), a two-dimensional micro-shutter array (MSA) developed by NASA/GSFC. The MSA is inserted in front of the detector to allow only the light from the galaxies of interest to reach the detector and to block the light from all other sources. The MSA will have to operate at 30 K to minimize the amount of thermal radiation emitted by the optical components from reaching the detector array. It will also have to operate in the space radiation environment that is dominated by the MSA will be exposed to a large total ionizing dose of approximately 200 krad(Si). Following exposure to ionizing radiation, a variety of MEMS have exhibited performance degradation. MEMS contain moving parts that are either controlled or sensed by changes in electric fields. Radiation degradation can be expected for those devices where there is an electric field applied across an insulating layer that is part of the sensing or controlling structure. Ionizing radiation will liberate charge (electrons and holes) in the insulating layers, some of which may be trapped within the insulating layer. Trapped charge will partially cancel the externally applied electric field and lead to changes in the operation of the MEMS. This appears to be a general principle for MEMS. Knowledge of the above principle has raised the concern at NASA that the MSA might also exhibit degraded performance because, i) each shutter flap is a multilayer structure consisting of metallic and insulating layers and ii) the movement of the shutter flaps is partially controlled by the application of an electric field between the shutter flap and the substrate (vertical support grid). The whole mission would be compromised if radiation exposure were to prevent the shutters from opening and closing properly. energetic ionizing particles. Because it is located A unique feature of the MSA is that, as outside the spacecraft and has very little shielding, previously mentioned, it will have to operate at temperatures near 30 K. To date, there are no published reports on how very low temperatures (- 30K) affect the response of MEMS devices to total ionizing dose. Experiments on SiO2 structures at low temperatures (80 K) indicate that the electrons generated by the ionizing radiation are mobile and will move rapidly under the application of an external electric field. Holes, on the other hand, that would normally move in the opposite direction through the SiO2 via a "thermal hopping" process, are effectively immobile at low electric fields as they are trapped close to their generation sites. However, for sufficiently large electric fields (greater than 3 MV/cm) holes are able to move through the SiO2. The larger the field, the more rapidly the holes move. The separation of the electrons and holes leads to a reduced electric field within the insulating layer. To overcome this reduction in electric field, a greater external voltage will have to be applied that alters the normal operation of the device. This report presents the results of radiation testing of the MSA at 60 K. The temperature was higher than the targeted temperature because of a faulty electrical interconnect on the test board. Specifically, our goal was to determine whether the MSA would function propey after a TID of 200 krad(Si)

Sibling interaction as a facilitator for talent development in sport

While current research has begun to address parental influences on talent development in sport, sibling interaction remains relatively under-examined. Therefore, this study aimed to explore the underpinning mechanisms through which sibling interaction impacts on talent development. Retrospective phenomenological interviews were conducted with four sets of siblings (N = 9), where at least one sibling had competed to an elite level. Findings revealed several higher-order themes that impacted positively on the talented athletes’ development: regularity of interaction in sport, emotional interpersonal skills, rivalry, resilience, co-operation and separation. Separation appeared as the athlete reached elite status, suggesting that these former mechanisms primarily impact during the development phase. Such findings support and extend the sibling, elite sport and talent development literature and provide valuable insight for both practitioners and academics. Importantly, coaches should consider a sibling’s role as an important mechanism outside of the formal coaching structure for talent development

An Early & Comprehensive Millimeter and Centimeter Wave and X-ray Study of Supernova 2011dh: A Non-Equipartition Blastwave Expanding into A Massive Stellar Wind

Only a handful of supernovae (SNe) have been studied in multi-wavelength from radio to X-rays, starting a few days after explosion. The early detection and classification of the nearby type IIb SN2011dh/PTF11eon in M51 provides a unique opportunity to conduct such observations. We present detailed data obtained at the youngest phase ever of a core-collapse supernova (days 3 to 12 after explosion) in the radio, millimeter and X-rays; when combined with optical data, this allows us to explore the early evolution of the SN blast wave and its surroundings. Our analysis shows that the expanding supernova shockwave does not exhibit equipartition (e_e/e_B ~ 1000), and is expanding into circumstellar material that is consistent with a density profile falling like R^-2. Within modeling uncertainties we find an average velocity of the fast parts of the ejecta of 15,000 +/- 1800 km/s, contrary to previous analysis. This velocity places SN 2011dh in an intermediate blast-wave regime between the previously defined compact and extended SN IIb subtypes. Our results highlight the importance of early (~ 1 day) high-frequency observations of future events. Moreover, we show the importance of combined radio/X-ray observations for determining the microphysics ratio e_e/e_B.Comment: 9 pages, 5 figures, submitted to Ap

Post-Newtonian SPH calculations of binary neutron star coalescence. I. Method and first results

We present the first results from our Post-Newtonian (PN) Smoothed Particle Hydrodynamics (SPH) code, which has been used to study the coalescence of binary neutron star (NS) systems. The Lagrangian particle-based code incorporates consistently all lowest-order (1PN) relativistic effects, as well as gravitational radiation reaction, the lowest-order dissipative term in general relativity. We test our code on sequences of single NS models of varying compactness, and we discuss ways to make PN simulations more relevant to realistic NS models. We also present a PN SPH relaxation procedure for constructing equilibrium models of synchronized binaries, and we use these equilibrium models as initial conditions for our dynamical calculations of binary coalescence. Though unphysical, since tidal synchronization is not expected in NS binaries, these initial conditions allow us to compare our PN work with previous Newtonian results. We compare calculations with and without 1PN effects, for NS with stiff equations of state, modeled as polytropes with $\Gamma=3$. We find that 1PN effects can play a major role in the coalescence, accelerating the final inspiral and causing a significant misalignment in the binary just prior to final merging. In addition, the character of the gravitational wave signal is altered dramatically, showing strong modulation of the exponentially decaying waveform near the end of the merger. We also discuss briefly the implications of our results for models of gamma-ray bursts at cosmological distances.Comment: RevTeX, 37 pages, 17 figures, to appear in Phys. Rev. D, minor corrections onl

Disease knowledge after an educational program in patients with GERD – a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Patient education has proved beneficial in several but not all chronic disease. Inconsistent findings may rely on varying educational effects of various programs and differential effects on subgroups of patients. Patients' increase in disease knowledge may serve as a feedback to the educator on how well the education program works – but may not be associated to relevant clinical outcomes like quality of life (QoL). This study aimed to investigate the effects of a group based education program for patients with gastroesophageal reflux disease (GERD) on disease knowledge and the association between knowledge and QoL.</p> <p>Methods</p> <p>Patients with GERD were randomly allocated to education (102 patients) or control (109 patients). The education program was designed as a structured dialogue conveying information about pathophysiology, pharmacological and non-pharmacological treatment of GERD, patients' rights and use of healthcare. Outcomes were a 24 item knowledge test on GERD (score 0 – 24) 2 and 12 months after the educational program and disease specific and general QoL (Digestive symptoms and disease impact, DSIQ, and General Health Questionnaire, GHQ).</p> <p>Results</p> <p>Patients allocated to education achieved higher knowledge test scores than controls at 2 months (17.0 vs. 13.1, p < 0.001) and at 12 months (17.1 vs. 14.0, p < 0.001) follow-up. Knowledge test score was positively associated with having completed advanced school and inversely related to psychiatric illness and poor QoL as perceived by the patients at the time of inclusion. Overall, changes in knowledge test score were not associated with change in QoL.</p> <p>Conclusion</p> <p>A group based education program for patients with GERD designed as a structured dialogue increased patients' disease knowledge, which was retained after 1 year. Changes in GERD-knowledge were not associated with change in QoL.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: NCT0061850</p