BACKGROUND: Endoscopic surveillance of patients with Barrett's oesophagus is recommended to detect early carcinoma. The practice patterns of endoscopists since the publication of more recent management guidelines remain unknown. METHODS: All endoscopists (n=68) in the Irish Medical Directory and their trainees were sent a postal questionnaire on Barrett's surveillance. RESULTS: Fifty-five per cent (30/54) perform surveillance on all patients with Barrett's oesophagus and 38% on selected patients. In patients with no dysplasia, repeat endoscopy was more commonly practiced annually (28/54) than every two to three years (23/54). Surgeons were more likely to perform surveillance annually than gastroenterologists (75% vs 40%). Only 26% of endoscopists took four-quadrant biopsies every 2 cm. Intervention was recommended by a majority (28/54) of endoscopists in a patient with high grade dysplasia. A majority of respondents (47/54) would have surveillance if they were found to have Barrett's oesophagus. CONCLUSION: Most endoscopists in Ireland do not adhere to recent guidelines in their management of Barrett's oesophagus. Surgical endoscopists perform surveillance more frequently than their medical colleagues.

Barrett Esophagus↗

PubMedDate not supplied

Assessment of variables contributing to cyclosporine distribution in blood.

Factors which can account for the poor correlation between whole blood and plasma Cyclosporine (CsA) levels in patients on CsA prophylaxis are evaluated. The study took account of the influence of plasma separation procedures, and the sample haematocrit on CsA distribution in the blood of renal transplant patients (n = 35). CsA was measured using both specific and non-specific CsA radioimmunoassays. Significant negative correlations occurred between CsA distribution and the haematocrit, independently of the plasma separation procedure or the specificity of the assay. All results were lower when using the specific assay but a significantly higher percentage of CsA was measured in the plasma by specific assay compared to nonspecific assay when plasma was separated at both 22 degrees C (t-test, p less than 0.02) and at 37 degrees C, p less than 0.01). This may relate to the selective binding of CsA and its analogues by blood cells. This study is a prelude to the development of more consistent plasma separation procedures in the monitoring of this drug.

Biological Availability↗

PubMedDate not supplied

The management of heart transplant recipients treated with cyclosporine in Ireland: monitoring of cyclosporine concentrations in blood.

Thirty seven cardiac transplants have taken place at the National Cardiac Centre in Ireland since 1985. Data is presented on three still-surviving male patients aged 19 to 42 who received cardiac transplants in 1985 and 1986. Circulating levels of blood cyclosporine were measured by high pressure liquid chromatography and radioimmunoassay; plasma creatinine and bilirubin were also measured. In one of these patients the distribution of cyclosporine in blood was measured by high pressure liquid chromatography in a long term study. For all three patients cyclosporine levels in blood were compared with the daily dose of cyclosporine and biochemical and histopathological parameters.

Adult↗

PubMedDate not supplied

Effect of oral metrizamide on hematocrit and serum osmolality in the neonate.

Sixteen newborns and young infants, weighing between 800 and 5200 grams, received orally administered metrizamide for evaluation of suspected gastrointestinal pathology. Images were judged good to excellent in 14 cases. No effect of metrizamide on hematocrit and serum osmolality was noted. Metrizamide appears to be a relatively safe and effective agent for examination of the neonatal gastrointestinal tract.

Administration, Oral↗

PubMedDate not supplied