Current Standard of Care for inpatient colonoscopy: The dose of PEG-ELS will be large-volume (4-Liter) administered as either single-dose if colonoscopy is scheduled BEFORE 11 a.m. (250 mL orally every 15 minutes between 6 p.m. and midnight the day prior to procedure), or split-dose if the colonoscopy is scheduled AT or AFTER 11 a.m. (First dose: 2-Liters; 250 mL orally every 15 minutes between 6-8 p.m. the day prior to procedure. Second dose: 2-Liters; 250 mL orally every 15 minutes to be completed 5 hours before the scheduled time of the procedure).

The study entails giving two doses of Lubiprostone in addition to the standard large-volume polythene glycol-electrolytes solution (PEG-ELS) according to the time of the procedure as follow: If the colonoscopy is scheduled BEFORE 11a.m. the patient will receive in addition to the PEG-ELS: Lubiprostone 24 mcg capsule orally (roughly every 12 hours) for total of 2 doses, with the last dose being at least 4 hours prior to the scheduled colonoscopy.
If the colonoscopy is scheduled AT or AFTER 11a.m. the patient will receive in addition to PEG-ELS: Lubiprostone 24 mcg capsule orally 2 hours before each dose of the PEG-ELS

Colonoscopy Preparation

Standard of care for inpatient colonoscopy

PEG-ELS current standard of care

The dose of Lubiprostone will be 24 mcg capsule orally (roughly every 12 hours) for total of 2 doses, with the last dose being at least 4 hours prior to the scheduled colonoscopy if it is BEFORE 11 a.m., and Lubiprostone 24 mcg capsule orally 2 hours before each dose of the PEG-ELS if colonoscopy is scheduled AT or AFTER 11 a.m..

PEG-ELS current standard of care plus Lubiprostone 24 microgram Oral Cap (x2)

Ascension Providence Hopsital (Novi)

Ascension Providence Hospital, Southfield Campus

Ascension Macomb-Oakland Hospital

The Effect of Adding Lubiprostone to Standard Large-Volume PEG-ELS on The Quality of Inpatient Colonoscopy Preparation

The Effect of Adding Lubiprostone to Standard Large-Volume PEG-ELS on The Quality of Inpatient Colonoscopy Preparation.

The Boston Bowel Preparation Scale (BBPS) is a four-point scoring system (0-3) applied to each of the three broad regions of the colon: the right colon (including the cecum and ascending colon), the transverse colon (including the hepatic and splenic flexures), and the left colon (including the descending colon, sigmoid colon, and rectum). Scores can range from 0-9.

Adverse symptoms following colonoscopy can range from none (0) to severe (4)

any EHR documented adverse event during current hospitalization

Ascension South East Michigan

whole blood, serum, white cells, red blood cells, urine, breast milk, meconium

Exposure to Environmental Pollution

Rambam Medical Center

Lis Medical Center

Assaf Harofeh Medical Center

Impact of Exposure to Environmental Pollutants on Birth Outcomes in an Israeli Cohort

assessment of BFRs and phthalates body burdens through measurement of these chemicals in maternal and paternal serum and urine, cord blood, breastmilk and neonatal meconium among several representative sub-populations

To examine associations between exposure to PBDEs and phthalates and (a) pregnancy complications, (b) anthropometrics at birth (i.e. birth weight adjusted for gestational age, ponderal index, head circumference adjusted for gestational age), and (c) cryptorchidism incidence, (d) maternal and infant thyroid function

To establish a bio repository of these media for future studies and to establish follow up methods for this cohort to later assess development and growth in the infants, toddlers and children

Assaf-Harofeh Medical Center

Placebo ( 0.9% Normal saline) intravenously given as a 0.5 ml/kg loading dose over 15 minutes followed by a 0.1 ml/kg/hr continuous infusion throughout the surgery.

Tranexamic acid 100 mg/ml; 50 mg/kg loading dose = 0.5 ml/kg LD given over 15 minutes and 10 mg/kg/hr = 0.1 ml/kg/hr infusion for the duration of the surgery.

Placebo ( 0.9% Normal saline) intravenously given as a 0.5 ml/kg loading dose over 15 minutes followed by a 0.1 ml/kg/hr continuous infusion throughout the surgery.
Placebo: Following a standardized general anesthetic protocol, patients coming with idiopathic scoliosis will be randomized to:
Placebo ( 0.9% Normal saline) intravenously given as a 0.5 ml/kg loading dose over 15 minutes followed by a 0.1 ml/kg/hr continuous infusion throughout the surgery or
TXA as previously described.

Placebo

Tranexamic acid 100 mg/ml; 50 mg/kg loading dose = 0.5 ml/kg LD given over 15 minutes and 10 mg/kg/hr = 0.1 ml/kg/hr infusion for the duration of the surgery.
Tranexamic Acid: Following a standardized general anesthetic protocol, patients coming with idiopathic scoliosis will be randomized to either:
placebo i.e. saline 0.9% (intravenous injection)
intravenous TXA given as a loading dose over 15 minutes of 50 mg/kg bolus ( within an hour prior to surgical incision) and 10 mg/kg/hr infusion for the duration of the surgery.

Tranexamic Acid

Total

Sex: Female, Male

Race (NIH/OMB)

weight

The ASA PHYSICAL STATUS CLASSIFICATION SYSTEM scale is 1-6, ASA 1 being the lowest risk and ASA4 being the higher risk as follows ( ASA 5 AND 6 DO NOT APPLY TO THIS POPULATION):
ASA I A normal healthy patient ASA II A patient with mild systemic disease ASA III A patient with severe systemic disease ASA IV A patient with severe systemic disease that is a constant threat to life ASA V A moribund patient who is not expected to survive without the operation ASA VI A declared brain-dead patient whose organs are being removed for donor purposes

American Society of Anesthesiology Physical Status Classification

Perioperative blood loss (during operation and for entire hospital admission)

Perioperative Blood Loss

Overall Study

susan Goobie, MD, FRCPC

Adolescent Idiopathic Scoliosis

Following a standardized general anesthetic protocol, patients coming with idiopathic scoliosis will be randomized to either:
placebo i.e. saline 0.9% (intravenous injection)
intravenous TXA given as a loading dose over 15 minutes of 50 mg/kg bolus ( within an hour prior to surgical incision) and 10 mg/kg/hr infusion for the duration of the surgery.

Following a standardized general anesthetic protocol, patients coming with idiopathic scoliosis will be randomized to:
Placebo ( 0.9% Normal saline) intravenously given as a 0.5 ml/kg loading dose over 15 minutes followed by a 0.1 ml/kg/hr continuous infusion throughout the surgery or
TXA as previously described.

ethylene/illamående

The Effect of Adding Lubiprostone to Standard Large-Volume PEG-ELS on The Quality of Inpatient Colonoscopy Preparation

Impact of Exposure to Environmental Pollutants on Birth Outcomes in an Israeli Cohort

Does Tranexamic Acid Decrease Blood Loss in Pediatric Idiopathic Scoliosis Surgery?

Pico-Salax Versus Poly-Ethylene Glycol for Bowel Cleanout Before Colonoscopy in Children

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