Natalia Terreni - Academia.edu (original) (raw)
Papers by Natalia Terreni
Liver International, 2014
Different prevalence of favourable IL28BCC genotype have been reported in studies performed in di... more Different prevalence of favourable IL28BCC genotype have been reported in studies performed in different countries around the world. Data on distribution of IL28B genotypes in healthy Italian subjects are lacking. Studies on prospectively collected untreated chronic HCV-infected Italian patients led to conflicting results. To investigate the prevalence of IL28B genotypes in untreated HCV-infected patients and in subjects able to clear HCV, and to compare them to the prevalence registered in healthy Italian controls. To evaluate IL28B prevalence across different HCV genotypes. IL28BCC was observed in 30.9% of chronic HCV patients, in 71.0% of subjects able to clear HCV infection and in 41.6% of the Italian controls. The frequency of IL28BCC was higher in HCV genotype 2 and 3 than in 1 (38.3 vs. 28.2) (P = 0.02). Levels of ALT higher in IL28BCC than in non-CC were observed regardless of HCV genotypes (P = 0.0014). IL28BCC frequencies progressively decline from subjects with spontaneous HCV clearance to normal non-infected subjects and to chronically infected. This study suggests that patients with IL28BCC, if genotype 1, are able to clear HCV more often than if genotype 2 and 3 infected, and that CC genotype is associated with higher grade of necro-inflammation.
Endoscopy, 2012
Introduction ! Colonoscopy has been proven to reduce the burden of colorectal cancer by preventin... more Introduction ! Colonoscopy has been proven to reduce the burden of colorectal cancer by preventing up to 60 % -80 % of incident lesions , and this benefit is essentially related to adenoma resection. As the endoscopic appearance of polyps under white light is poorly reliable in predicting the presence of adenomatous tissue [3], up to now all of the detected polyps have been removed and sent for pathologic assessment. Post-polypectomy surveillance timing is driven by histologic features, along with size and number of resected adenomas . However, the role of advanced histologic features for guiding surveillance is being debated, as villous component or high grade dysplasia at index colonoscopy are inconsistent predictors of subsequent advanced neoplasia . This might suggest that an endoscopic diagnosis of adenoma might allow the determination of polyp management and surveillance interval, particularly in patients with small polyps (< 10 mm), in which the advanced histologic features are uncommon and the prevalence of invasive cancer is very low [6]. Real-time imaging technologies have shown promising results in discriminating adenomatous from non-adenomatous polyps . In particular, narrow-band imaging (NBI) allows the visualization of density and shape of surface microvessels as dark brown structures, and it has shown a sensitivity ranging from 83 % to 97 % and a specificity from 64 % to 100 % across the studies for the diagnosis of adenoma . The application of this technology in patients with small polyps, which con-Paggi S et al. Resect and discard strategy in clinical practice … Endoscopy 2012; 44: 899-904
Digestive and Liver Disease, 2009
to evaluate the possible role of a CS in the assessment of competence of trainees after hands-on-... more to evaluate the possible role of a CS in the assessment of competence of trainees after hands-on-training. Material and methods: Eleven trainees, already fully trained in upper GI endoscopy, underwent evaluation at CS (GI-Mentor, Symbionix) before and after traditional hands-on-training in colonoscopy. Items at hands-on-training, i.e. % of caecal intubation and % of incomplete colonoscopies due to difficult loop, were calculated for three phases: colonoscopies 1-20 (phase 1), 21-40 (phase 2) and 41-60 (phase 3). Results at CS of fifteen experts (with > 90% of caecal intubation) were used as controls. Both trainees and experts were asked to perform two simulations (easy and difficult) in a randomized order. At CS items shown in table were evaluated. Trainees' results after hands-on-training (post) were compared to results before it (pre) and to experts' ones. Regression analysis was used to correlate items at CS with those at hands-on-training. Results: Medians (IQ range). During hands-on-training trainees performed overall 771 colonoscopies during 5 (4-6) months. Percentage of caecal intubation was 20 (15-55)%, 35 (19-48)% and 60 (43-69)% in the three phases, respectively (p<0.05 for phase 3 vs phase 1 and phase 2). Percentage of incomplete colonoscopies due to difficult loop was 93 (61-100)%, 92 (68-100)% and 67 (54-89)%, p=NS. No complications occurred. At CS all trainees intubated the caecum at easy and difficult simulation, both before and after hands-on-training. See items at easy simulation in the table. Difficult simulation showed similar results.
Alimentary Pharmacology Therapeutics, 2005
Gastrointest Endoscop, 2001
Liver International, 2014
Different prevalence of favourable IL28BCC genotype have been reported in studies performed in di... more Different prevalence of favourable IL28BCC genotype have been reported in studies performed in different countries around the world. Data on distribution of IL28B genotypes in healthy Italian subjects are lacking. Studies on prospectively collected untreated chronic HCV-infected Italian patients led to conflicting results. To investigate the prevalence of IL28B genotypes in untreated HCV-infected patients and in subjects able to clear HCV, and to compare them to the prevalence registered in healthy Italian controls. To evaluate IL28B prevalence across different HCV genotypes. IL28BCC was observed in 30.9% of chronic HCV patients, in 71.0% of subjects able to clear HCV infection and in 41.6% of the Italian controls. The frequency of IL28BCC was higher in HCV genotype 2 and 3 than in 1 (38.3 vs. 28.2) (P = 0.02). Levels of ALT higher in IL28BCC than in non-CC were observed regardless of HCV genotypes (P = 0.0014). IL28BCC frequencies progressively decline from subjects with spontaneous HCV clearance to normal non-infected subjects and to chronically infected. This study suggests that patients with IL28BCC, if genotype 1, are able to clear HCV more often than if genotype 2 and 3 infected, and that CC genotype is associated with higher grade of necro-inflammation.
American Journal of Gastroenterology, 2003
Journal of Hepatology, 2002
... Gunsar, F and Raimondo, ML and Terreni, N and Wong, C and Patch, D and Sabin, C and Burroughs... more ... Gunsar, F and Raimondo, ML and Terreni, N and Wong, C and Patch, D and Sabin, C and Burroughs, AK (2002) Nutritional status and renal function in the prognostic evaluation of cirrhosis: Comparison with Pugh's score and MELD. In: Journal of Hepatology. (pp. 53 - ?). ...
Journal of Hepatology, 2004
Journal of Hepatology, 2012
Journal of Clinical Gastroenterology, 2008
Efficacy of symbiotics in patients with irritable bowel syndrome (IBS) remains unknown. Patients ... more Efficacy of symbiotics in patients with irritable bowel syndrome (IBS) remains unknown. Patients were randomized to a prebiotic (n=135), or a symbiotic formulation containing Lactobacillus paracasei B21060 (Flortec, n=132). Primary efficacy was the responder rate for pain and global relief of symptoms in the overall population and in patients with predominant diarrhea (n=47). Post hoc time-trend analyses for changes within each treatment were carried out. Patients with absent/mild pain amounted to 54.7% in the symbiotic group and to 57.4% in the prebiotic group at treatment week 4, and to 53.9% and 53.4% at the end of treatment. Patients with amelioration of well-being were, respectively, 60.7% versus 61.7% at treatment week 4, and 63.3% versus 60.9% at the end of treatment. Within each treatment group, patients with absent/mild pain increased in the Flortec and the prebiotic group, but time trend analyses were significant only for Flortec (P=0.019). In IBS-predominant diarrhea, Flortec significantly reduced bowel movements, pain, and IBS scores. To improve pain and well-being, Flortec is encouraging in patients with diarrhea predominant IBS. To establish its efficacy for the majority of IBS patients, Flortec has to be compared with an inert placebo in future work.
Hepatology, 2001
To determine whether a higher dosage of interferon (IFN) associated with ribavirin and/or prolong... more To determine whether a higher dosage of interferon (IFN) associated with ribavirin and/or prolonged time of administration may improve therapeutic efficacy, we conducted a 4-arm randomized trial on patients with chronic hepatitis C not responding to one or more previous treatment courses with IFN monotherapy. Group 1 (n ؍ 139) received 3 million units (MU) IFN-␣2b 3 times a week (t.i.w.) plus ribavirin 1,000 mg/d for 12 months; group 2 (n ؍ 162) received 5 MU t.i.w. plus ribavirin for 12 months; group 3 (n ؍ 142) received 3 MU t.i.w. plus ribavirin for 6 months; and group 4 (n ؍ 151) received 5 MU t.i.w. plus ribavirin for 6 months. The primary end point was hepatitis C virus (HCV)-RNA clearance at the end of 6-month follow-up. HCV-RNA was negative in 15% of group 1, 23% of group 2, 11% of group 3, 16% of group 4 (group 2 vs. group 3, P ؍ .04). Among patients with genotypes 1 and 4, sustained response was significantly higher in group 2 vs. group 3 (18% vs. 7%, P ؍ .03; group 1 ؍ 9%, group 4 ؍ 12%, P ؍ not significant [NS]). In patients with genotypes 2 and 3, sustained virologic response was not affected by the different regimens (group 1 ؍ 32%, group 2 ؍ 30%, group 3 ؍ 30%, group 4 ؍ 35%, P ؍ NS). In conclusion, about 23% of nonresponders to IFN monotherapy may achieve a sustained response if re-treated by 5 MU t.i.w. IFN plus ribavirin 1,000 mg/d for 1 year. Patients with genotype 1 should receive a high dosage of IFN plus ribavirin for 12 months, whereas therapy for patients with genotype 2 or 3 should be less aggressive. (HEPATOLOGY 2001;34:133-138.) Abbreviations: IFN, interferon alfa-2b; MU, million units; t.i.w., three times a week; ALT, alanine transaminase; HCV, hepatitis C virus; PCR, polymerase chain reaction; SR-B, sustained biochemical response; SR-V, sustained virological response; OR, odds ratio; C.I., confidence interval; NS, not significant.
Hepatology, 2008
2. Tesiram YA, Saunders D, Towner RA. Application of proton NMR spectroscopy in the study of lipi... more 2. Tesiram YA, Saunders D, Towner RA. Application of proton NMR spectroscopy in the study of lipid metabolites in a rat hepatocarcinogenesis model. Biochim Biophys Acta 2005;1737:61-68. 3. Martinez-Granados B, Monleón D, Martinez-Bisbal MC, Rodrigo JM, del Olmo J, Lluch P, et al. Metabolite identification in human liver needle biopsies by high-resolution magic angle spinning 1H NMR spectroscopy. NMR Biomed 2006;19:90-100. 4. Araya J, Rodrigo R, Videla LA, Thielemann L, Orellana M, Pettinelli P, et
Gastrointestinal Endoscopy, 2003
Background: The aim of this study was to determine whether a single bolus of meperidine in additi... more Background: The aim of this study was to determine whether a single bolus of meperidine in addition to midazolam improves patient tolerance during colonoscopy. Methods: Consecutive patients undergoing outpatient colonoscopy were randomly assigned in double-blind fashion to receive a single rapid intravenous bolus of 5 mg of midazolam and placebo (Group A, n = 125) or 5 mg midazolam plus 50 mg meperidine (Group B, n = 128). Tolerance (4-point scale: 1 excellent, 4 unbearable), pain (4-point scale: 1 none, 4 severe) and willingness to undergo another colonoscopy were assessed 24 to 48 hours later in a telephone interview conducted by an independent observer blinded to the regimen of sedative medication. Results: Significantly more patients in Group A reported moderate or severe pain (28% vs. 9%; p < 0.001), poor or unbearable tolerance (18% vs. 6%; p < 0.01) and unwillingness to undergo colonoscopy again in the future (14% vs. 5%; p < 0.05). By multivariate analysis, randomization to the midazolam group and younger age were the only variables independently associated with the risk of reporting at least one of these outcomes. Recovery time, frequency of oxygen desaturation, and need for supplemental oxygen were not significantly different between the 2 groups. Conclusions: The addition of a single bolus of meperidine to midazolam improves patient tolerance and lessens pain during colonoscopy without significantly increasing the frequency of side effects or prolonging recovery time. (Gastrointest Endosc 2003;57:329-35.) F Radaelli, G Meucci, V Terruzzi, et al. Colonoscopy: midazolam vs. midazolam plus meperidine
Gastrointestinal Endoscopy, 2010
Gastrointestinal Endoscopy, 2001
The safety and tolerance of routine sedation and analgesia versus "on demand" sedation were compa... more The safety and tolerance of routine sedation and analgesia versus "on demand" sedation were compared in patients undergoing colonoscopy. Methods: Two hundred forty-nine outpatients were randomly assigned to one of two groups. Group A (n = 125) received midazolam, 0.07 mg/kg intravenously plus meperidine, 0.77 mg/kg intravenously immediately preceding the colonoscope insertion. Group B (n = 124) received the same medication upon request during the procedure. Tolerance was assessed 24 hours later by phone interview performed by a nurse blinded to the medication regimen administered. Results: Eighty-three patients (66%) in Group B required sedation during colonoscopy. Among men in Group B more than 60 years of age, only 23% required sedation. The proportion of patients reporting moderate or severe pain (34% vs. 12.1%, p < 0.001) and of those stating they would not be willing to undergo colonoscopy again in the future (22% vs. 9.7%, p < 0.005) was significantly higher in the "on demand" sedation group. By multivariate analysis the randomization group was the single variable independently associated with both such outcomes. The frequency of side effects was similar in the two groups. Conclusions: Administration of sedative and analgesic drugs routinely before colonoscopy is superior to "on demand" sedation in terms of tolerance and is not associated with an increase in side effects. (Gastrointest Endosc 2001;54:169-74.)
Liver International, 2014
Different prevalence of favourable IL28BCC genotype have been reported in studies performed in di... more Different prevalence of favourable IL28BCC genotype have been reported in studies performed in different countries around the world. Data on distribution of IL28B genotypes in healthy Italian subjects are lacking. Studies on prospectively collected untreated chronic HCV-infected Italian patients led to conflicting results. To investigate the prevalence of IL28B genotypes in untreated HCV-infected patients and in subjects able to clear HCV, and to compare them to the prevalence registered in healthy Italian controls. To evaluate IL28B prevalence across different HCV genotypes. IL28BCC was observed in 30.9% of chronic HCV patients, in 71.0% of subjects able to clear HCV infection and in 41.6% of the Italian controls. The frequency of IL28BCC was higher in HCV genotype 2 and 3 than in 1 (38.3 vs. 28.2) (P = 0.02). Levels of ALT higher in IL28BCC than in non-CC were observed regardless of HCV genotypes (P = 0.0014). IL28BCC frequencies progressively decline from subjects with spontaneous HCV clearance to normal non-infected subjects and to chronically infected. This study suggests that patients with IL28BCC, if genotype 1, are able to clear HCV more often than if genotype 2 and 3 infected, and that CC genotype is associated with higher grade of necro-inflammation.
Endoscopy, 2012
Introduction ! Colonoscopy has been proven to reduce the burden of colorectal cancer by preventin... more Introduction ! Colonoscopy has been proven to reduce the burden of colorectal cancer by preventing up to 60 % -80 % of incident lesions , and this benefit is essentially related to adenoma resection. As the endoscopic appearance of polyps under white light is poorly reliable in predicting the presence of adenomatous tissue [3], up to now all of the detected polyps have been removed and sent for pathologic assessment. Post-polypectomy surveillance timing is driven by histologic features, along with size and number of resected adenomas . However, the role of advanced histologic features for guiding surveillance is being debated, as villous component or high grade dysplasia at index colonoscopy are inconsistent predictors of subsequent advanced neoplasia . This might suggest that an endoscopic diagnosis of adenoma might allow the determination of polyp management and surveillance interval, particularly in patients with small polyps (< 10 mm), in which the advanced histologic features are uncommon and the prevalence of invasive cancer is very low [6]. Real-time imaging technologies have shown promising results in discriminating adenomatous from non-adenomatous polyps . In particular, narrow-band imaging (NBI) allows the visualization of density and shape of surface microvessels as dark brown structures, and it has shown a sensitivity ranging from 83 % to 97 % and a specificity from 64 % to 100 % across the studies for the diagnosis of adenoma . The application of this technology in patients with small polyps, which con-Paggi S et al. Resect and discard strategy in clinical practice … Endoscopy 2012; 44: 899-904
Digestive and Liver Disease, 2009
to evaluate the possible role of a CS in the assessment of competence of trainees after hands-on-... more to evaluate the possible role of a CS in the assessment of competence of trainees after hands-on-training. Material and methods: Eleven trainees, already fully trained in upper GI endoscopy, underwent evaluation at CS (GI-Mentor, Symbionix) before and after traditional hands-on-training in colonoscopy. Items at hands-on-training, i.e. % of caecal intubation and % of incomplete colonoscopies due to difficult loop, were calculated for three phases: colonoscopies 1-20 (phase 1), 21-40 (phase 2) and 41-60 (phase 3). Results at CS of fifteen experts (with > 90% of caecal intubation) were used as controls. Both trainees and experts were asked to perform two simulations (easy and difficult) in a randomized order. At CS items shown in table were evaluated. Trainees' results after hands-on-training (post) were compared to results before it (pre) and to experts' ones. Regression analysis was used to correlate items at CS with those at hands-on-training. Results: Medians (IQ range). During hands-on-training trainees performed overall 771 colonoscopies during 5 (4-6) months. Percentage of caecal intubation was 20 (15-55)%, 35 (19-48)% and 60 (43-69)% in the three phases, respectively (p<0.05 for phase 3 vs phase 1 and phase 2). Percentage of incomplete colonoscopies due to difficult loop was 93 (61-100)%, 92 (68-100)% and 67 (54-89)%, p=NS. No complications occurred. At CS all trainees intubated the caecum at easy and difficult simulation, both before and after hands-on-training. See items at easy simulation in the table. Difficult simulation showed similar results.
Alimentary Pharmacology Therapeutics, 2005
Gastrointest Endoscop, 2001
Liver International, 2014
Different prevalence of favourable IL28BCC genotype have been reported in studies performed in di... more Different prevalence of favourable IL28BCC genotype have been reported in studies performed in different countries around the world. Data on distribution of IL28B genotypes in healthy Italian subjects are lacking. Studies on prospectively collected untreated chronic HCV-infected Italian patients led to conflicting results. To investigate the prevalence of IL28B genotypes in untreated HCV-infected patients and in subjects able to clear HCV, and to compare them to the prevalence registered in healthy Italian controls. To evaluate IL28B prevalence across different HCV genotypes. IL28BCC was observed in 30.9% of chronic HCV patients, in 71.0% of subjects able to clear HCV infection and in 41.6% of the Italian controls. The frequency of IL28BCC was higher in HCV genotype 2 and 3 than in 1 (38.3 vs. 28.2) (P = 0.02). Levels of ALT higher in IL28BCC than in non-CC were observed regardless of HCV genotypes (P = 0.0014). IL28BCC frequencies progressively decline from subjects with spontaneous HCV clearance to normal non-infected subjects and to chronically infected. This study suggests that patients with IL28BCC, if genotype 1, are able to clear HCV more often than if genotype 2 and 3 infected, and that CC genotype is associated with higher grade of necro-inflammation.
American Journal of Gastroenterology, 2003
Journal of Hepatology, 2002
... Gunsar, F and Raimondo, ML and Terreni, N and Wong, C and Patch, D and Sabin, C and Burroughs... more ... Gunsar, F and Raimondo, ML and Terreni, N and Wong, C and Patch, D and Sabin, C and Burroughs, AK (2002) Nutritional status and renal function in the prognostic evaluation of cirrhosis: Comparison with Pugh's score and MELD. In: Journal of Hepatology. (pp. 53 - ?). ...
Journal of Hepatology, 2004
Journal of Hepatology, 2012
Journal of Clinical Gastroenterology, 2008
Efficacy of symbiotics in patients with irritable bowel syndrome (IBS) remains unknown. Patients ... more Efficacy of symbiotics in patients with irritable bowel syndrome (IBS) remains unknown. Patients were randomized to a prebiotic (n=135), or a symbiotic formulation containing Lactobacillus paracasei B21060 (Flortec, n=132). Primary efficacy was the responder rate for pain and global relief of symptoms in the overall population and in patients with predominant diarrhea (n=47). Post hoc time-trend analyses for changes within each treatment were carried out. Patients with absent/mild pain amounted to 54.7% in the symbiotic group and to 57.4% in the prebiotic group at treatment week 4, and to 53.9% and 53.4% at the end of treatment. Patients with amelioration of well-being were, respectively, 60.7% versus 61.7% at treatment week 4, and 63.3% versus 60.9% at the end of treatment. Within each treatment group, patients with absent/mild pain increased in the Flortec and the prebiotic group, but time trend analyses were significant only for Flortec (P=0.019). In IBS-predominant diarrhea, Flortec significantly reduced bowel movements, pain, and IBS scores. To improve pain and well-being, Flortec is encouraging in patients with diarrhea predominant IBS. To establish its efficacy for the majority of IBS patients, Flortec has to be compared with an inert placebo in future work.
Hepatology, 2001
To determine whether a higher dosage of interferon (IFN) associated with ribavirin and/or prolong... more To determine whether a higher dosage of interferon (IFN) associated with ribavirin and/or prolonged time of administration may improve therapeutic efficacy, we conducted a 4-arm randomized trial on patients with chronic hepatitis C not responding to one or more previous treatment courses with IFN monotherapy. Group 1 (n ؍ 139) received 3 million units (MU) IFN-␣2b 3 times a week (t.i.w.) plus ribavirin 1,000 mg/d for 12 months; group 2 (n ؍ 162) received 5 MU t.i.w. plus ribavirin for 12 months; group 3 (n ؍ 142) received 3 MU t.i.w. plus ribavirin for 6 months; and group 4 (n ؍ 151) received 5 MU t.i.w. plus ribavirin for 6 months. The primary end point was hepatitis C virus (HCV)-RNA clearance at the end of 6-month follow-up. HCV-RNA was negative in 15% of group 1, 23% of group 2, 11% of group 3, 16% of group 4 (group 2 vs. group 3, P ؍ .04). Among patients with genotypes 1 and 4, sustained response was significantly higher in group 2 vs. group 3 (18% vs. 7%, P ؍ .03; group 1 ؍ 9%, group 4 ؍ 12%, P ؍ not significant [NS]). In patients with genotypes 2 and 3, sustained virologic response was not affected by the different regimens (group 1 ؍ 32%, group 2 ؍ 30%, group 3 ؍ 30%, group 4 ؍ 35%, P ؍ NS). In conclusion, about 23% of nonresponders to IFN monotherapy may achieve a sustained response if re-treated by 5 MU t.i.w. IFN plus ribavirin 1,000 mg/d for 1 year. Patients with genotype 1 should receive a high dosage of IFN plus ribavirin for 12 months, whereas therapy for patients with genotype 2 or 3 should be less aggressive. (HEPATOLOGY 2001;34:133-138.) Abbreviations: IFN, interferon alfa-2b; MU, million units; t.i.w., three times a week; ALT, alanine transaminase; HCV, hepatitis C virus; PCR, polymerase chain reaction; SR-B, sustained biochemical response; SR-V, sustained virological response; OR, odds ratio; C.I., confidence interval; NS, not significant.
Hepatology, 2008
2. Tesiram YA, Saunders D, Towner RA. Application of proton NMR spectroscopy in the study of lipi... more 2. Tesiram YA, Saunders D, Towner RA. Application of proton NMR spectroscopy in the study of lipid metabolites in a rat hepatocarcinogenesis model. Biochim Biophys Acta 2005;1737:61-68. 3. Martinez-Granados B, Monleón D, Martinez-Bisbal MC, Rodrigo JM, del Olmo J, Lluch P, et al. Metabolite identification in human liver needle biopsies by high-resolution magic angle spinning 1H NMR spectroscopy. NMR Biomed 2006;19:90-100. 4. Araya J, Rodrigo R, Videla LA, Thielemann L, Orellana M, Pettinelli P, et
Gastrointestinal Endoscopy, 2003
Background: The aim of this study was to determine whether a single bolus of meperidine in additi... more Background: The aim of this study was to determine whether a single bolus of meperidine in addition to midazolam improves patient tolerance during colonoscopy. Methods: Consecutive patients undergoing outpatient colonoscopy were randomly assigned in double-blind fashion to receive a single rapid intravenous bolus of 5 mg of midazolam and placebo (Group A, n = 125) or 5 mg midazolam plus 50 mg meperidine (Group B, n = 128). Tolerance (4-point scale: 1 excellent, 4 unbearable), pain (4-point scale: 1 none, 4 severe) and willingness to undergo another colonoscopy were assessed 24 to 48 hours later in a telephone interview conducted by an independent observer blinded to the regimen of sedative medication. Results: Significantly more patients in Group A reported moderate or severe pain (28% vs. 9%; p < 0.001), poor or unbearable tolerance (18% vs. 6%; p < 0.01) and unwillingness to undergo colonoscopy again in the future (14% vs. 5%; p < 0.05). By multivariate analysis, randomization to the midazolam group and younger age were the only variables independently associated with the risk of reporting at least one of these outcomes. Recovery time, frequency of oxygen desaturation, and need for supplemental oxygen were not significantly different between the 2 groups. Conclusions: The addition of a single bolus of meperidine to midazolam improves patient tolerance and lessens pain during colonoscopy without significantly increasing the frequency of side effects or prolonging recovery time. (Gastrointest Endosc 2003;57:329-35.) F Radaelli, G Meucci, V Terruzzi, et al. Colonoscopy: midazolam vs. midazolam plus meperidine
Gastrointestinal Endoscopy, 2010
Gastrointestinal Endoscopy, 2001
The safety and tolerance of routine sedation and analgesia versus "on demand" sedation were compa... more The safety and tolerance of routine sedation and analgesia versus "on demand" sedation were compared in patients undergoing colonoscopy. Methods: Two hundred forty-nine outpatients were randomly assigned to one of two groups. Group A (n = 125) received midazolam, 0.07 mg/kg intravenously plus meperidine, 0.77 mg/kg intravenously immediately preceding the colonoscope insertion. Group B (n = 124) received the same medication upon request during the procedure. Tolerance was assessed 24 hours later by phone interview performed by a nurse blinded to the medication regimen administered. Results: Eighty-three patients (66%) in Group B required sedation during colonoscopy. Among men in Group B more than 60 years of age, only 23% required sedation. The proportion of patients reporting moderate or severe pain (34% vs. 12.1%, p < 0.001) and of those stating they would not be willing to undergo colonoscopy again in the future (22% vs. 9.7%, p < 0.005) was significantly higher in the "on demand" sedation group. By multivariate analysis the randomization group was the single variable independently associated with both such outcomes. The frequency of side effects was similar in the two groups. Conclusions: Administration of sedative and analgesic drugs routinely before colonoscopy is superior to "on demand" sedation in terms of tolerance and is not associated with an increase in side effects. (Gastrointest Endosc 2001;54:169-74.)