73 research outputs found
Diagnostic imaging and radiation exposure in inflammatory bowel disease.
No full textDiagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease (IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography (CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging (MRI) and small intestine contrast enhanced ultrasonography (SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT
Eco-friendly Recycled Crushed Glass for Cushioning Boulder Impacts
No full textA large amount of waste glass is generated every year and contributes significantly to landfills. Large-scale physical model tests were carried out to study the dynamic response of recycled crushed glass (RCG) contained in gabion baskets and its performance against successive boulder impacts at energy levels of up to 70 kJ. The cushioning performance of RCG is compared with that of more conventional cushioning materials, including rock fragments and cellular glass aggregates. Results reveal that for the first impact, RCG can provide up to 144% and 128% reduction in the transmitted wall loads and boulder impact loads respectively when compared to cushion layers comprising rock fragments. It follows that by adopting RCG, practitioners could potentially reduce the recommended design load for impact by a single boulder by up to three times. Furthermore, the load-diffusion angle of RCG is three times larger than that of cellular glass aggregates. The observed trend in the diffusion angle implies that the transmitted load for RCG is distributed more uniformly on the barrier wall compared to cellular glass aggregates.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
Temporal trends in imaging and associated radiation exposure in inflammatory bowel disease.
No full textOBJECTIVES: Increasing use of diagnostic imaging in inflammatory bowel disease (IBD) has led to concerns about the malignant potential of ionising radiation in a cohort that have an increased lifetime risk of gastrointestinal malignancy. The aim was to quantify radiation exposure in IBD patients referred from primary care, determine predictors of high exposure and evaluate temporal trends in diagnostic imaging over a 20-year period. METHODS: This was a retrospective cohort study whereby IBD patients were recruited from the outpatient clinic and evaluated retrospectively. The total cumulative effective dose (CED) received from tests was calculated for each subject. Cox regression was performed to assess factors associated with potentially harmful levels of ionising radiation defined as total CED > 50 milli-sieverts (mSv; equivalent to five CT abdomen scans). RESULTS: The cohort included 415 patients. Median total CED was 7.2 mSv (IQR: 3.0-22.7) in Crohn's disease and 2.8 mSv (IQR: 0.8-8.9) in ulcerative colitis patients, respectively. A total of 32 patients (8%) received a CED > 50 mSv. A history of IBD-related surgery was associated with high exposure (HR 7.7). During the study period, usage of abdominal CT increased by 310%. CONCLUSION: Approximately 1 in 13 patients in the study cohort were exposed to potentially harmful levels of ionising radiation. Strategies to minimise exposure to diagnostic medical radiation in IBD patients are required
Preoperative steroid use and risk of postoperative complications in patients with inflammatory bowel disease undergoing abdominal surgery.
No full textCONTEXT: Corticosteroids are the mainstay of medical therapies to induce remission in acute episodes of inflammatory bowel disease (IBD). However, evidence suggests that this may increase the risk of postoperative complications among patients with IBD who go on to have abdominal surgery. OBJECTIVE: To estimate the risk of postoperative complications following abdominal surgery in patients with IBD on steroids at the time of abdominal surgery. DESIGN: Meta-analysis of observational studies. METHODS: We searched medical electronic databases for full journal articles published after 1965 reporting on postoperative complications in patients with IBD undergoing abdominal surgery provided they compared patients treated with steroids with those not on steroids. We hand searched the reference lists of all retrieved articles. Two independent reviewers extracted data from studies meeting the inclusion criteria and any discrepancies were resolved by discussion. We carried out fixed effects meta-analysis, funnel plot and sensitivity analyses. RESULTS: A total of seven observational studies involving 1,532 patients met the inclusion criteria for risk of total complications, and five observational studies involving 1,714 patients met the inclusion criteria for risk of infectious complications. Pooled analysis showed an increased risk of all postoperative complications (OR 1.41, 95% confidence interval 1.07-1.87), as well as an increased risk of postoperative infectious complications (OR 1.68, 95% confidence interval 1.24-2.28) among patients on steroids. Patients who received higher doses of perioperative oral steroids (>40 mg) had a higher risk of total complications (OR 2.04 (95% CI 1.28-3.26). CONCLUSIONS: There is an increased risk of total as well as infectious complications following the use of steroids in patients with IBD
Where the speed matters : Zero-response-time search engine for small collections
No full textUsers with slow internet connections experience slow retrieval
of results in web catalogues. JavaScript search engines can be used to enable
client side search, reducing the load on the server, and increasing the response
time. However, it is not a popular method until now, because of various reasons
including limitation of number of data objects and lengthier response time for
the first search. Here the author suggests negotiating the issue of response
delay with the user. This would enable high speed basic search in small
catalogues, usually with less than 300 data objects. Larger catalogues can be
divided into smaller ones. Special or rare collections, multimedia artifacts and
subject (web) directories are prospective candidates for this type of search
systems. A prototype catalogue of ‘Sri Lankan Web Sites’ was tested in
www.srilankasupersearch.com. Users’ behavior and response to the system is
yet to be studied
The hybrid detailed / statistical opacity code SCO-RCG: New developments and applications
No full textChanging nationwide patterns in UK admissions for medical therapy, surgery, lower gi endoscopy and anti-tnf infusions for inflammatory bowel disease between 2003-2013
No full textEffect of Particle Size on Mechanical Properties of Pellets Made from Biomass Blends
No full textAbstractWoody biomass is densified in the form of pellets in order to improve its physical and mechanical properties during handling and storage. However, limited research work has been conducted on the mechanical properties of pellets made from agricultural and wood biomass blends. Two commonly available forestry biomass, spruce (S) and pine (P), and three agricultural biomasses, reed canary grass (RCG), timothy hay (H) and switchgrass (SW), were used to form pellets. The mechanical properties were evaluated for three different particle sizes (150-300, 300-425 and 425-600μm). An Instron attached with an in-house built single unit pelletizer and temperature controlled die was employed to produce a pellet. The aim of this study is to investigate the effect of particle size and blending (agricultural and woody biomass) on the mechanical properties (density and intrinsic yield stress). For all biomasses, pellets made from lower particle size (150-300μm) exhibited higher density (950-1178kg/m3 for spruce and pine; 668-800kg/m3 for RCG, H and SW; 900-970kg/m3 for blended biomass). The intrinsic yield stress exhibited differences in values for individual forestry (40MPa) and agricultural biomass (27-48MPa), however after blending the values converged closest to that value for forestry biomass. In conclusion, blending low cost and abundant available agricultural biomass with woody biomass could not only result in better mechanical properties but would also help to meet the pellet market demand in future
Parasitic colitis misdiagnosis as inflammatory bowel disease in high-income settings and association with poor clinical outcomes when exposed to corticosteroids: a systematic review of case reports
No full textSteroid use and misuse: a key performance indicator in the management of IBD
No full textCorticosteroids remain an important tool for inducing remission in inflammatory bowel disease (IBD) but they have no role in maintenance of remission. The significant adverse side effect profile of these drugs means their use should be avoided where possible or measures taken to reduce their risk. Despite an expanding array of alternative therapies, corticosteroid dependency and excess remain common. Appropriate steroid use is now regarded a key performance indicator in the management of IBD. This article aims to outline indications for corticosteroid use in IBD, their risks and strategies to reduce their use and misuse
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