Background: Propofol is recommended for sedation in gastrointestinal endoscopy (GE), but preliminary data suggest addictive potentials. Objective: The objective of this article is to evaluate the frequency of predominantly euphoric reaction after GE and patients' subsequent reminiscences. Methods: Eighty-two patients undergoing elective GE under propofol sedation were enrolled in a prospective observational study. The grade of anxiety, expectation or relief about the examination's result and affective state in terms of cheerfulness, relaxation, activation, sedation and anxiety were surveyed using a numeric rating scale (1 to 10) immediately before (t1), after GE (t2) and seven days (t3) later. Statistics: hierarchical cluster analysis, heat map, 2 test and paired t test. Results: Mean propofol dosage was 264 AE 120 mg. Two clusters of mood changes emerged (t1 vs. t2). One (n ¼ 46, 56.1%) was characterized by an unease reaction pattern with equal values regarding cheerfulness, relaxation and anxiety, while relaxation decreased; the other cluster showed a euphoric reaction pattern (n ¼ 36, 43.9%) with markedly increased cheerfulness, relaxation and decreased anxiety. These effects intensified at recall (t3). Despite similar endoscopy results, euphoric cluster patients rated these more positively. Conclusion: Propofol induces euphoria in nearly half of the patients undergoing elective GE with persisting, even enhanced reminiscence (germanctr.de, trial number DRKS00011202). KeywordsGastrointestinal endoscopy, propofol sedation, psychotropic effects, addiction Received: 31 July 2017; accepted: 17 September 2017 Key summary 1. Summarize the established knowledge on this subject.. Propofol is recommended for sedation in gastrointestinal endoscopy.. Propofol has shown euphoric reaction patterns and addictive potentials in healthy volunteers. 2. What are the significant and/or new findings of this study?. Propofol induces euphoria in nearly half of the patients undergoing gastrointestinal endoscopy.. The memory of euphoria persists and even enhances over time.

@ERSpublications Benzodiazepines, regardless of half-life, are associated with adverse respiratory outcomes across COPD severity

There is presented the structure of acute intestinal infections (AIIs) at the outpatient stage of medical care in 135 outpatients (70 men and 65 women, aged from 15 to 55 years) visited the Health Center of Barnaul. In all patients, the mild course of gastroenteritis predominated (the stool frequency did not exceed 4-5 times a day, body temperature - 37.2 0C). The investigation of biological material from patients (feces) was carried out by polymerase chain reaction (PCR) with hybridization-fluorescent detection “AmpliSens® AII screen-FL”. The results showed the high efficiency of the test system used, as in 118 out of 135 samples (87%) there was found genetic material of different etiology, 66.1% were of the viral origin, among which rotaviruses and noroviruses prevailed, 25.4% of samples had bacterial origin (Salmonella prevailed) and 19.5% of mixed virus-viral or bacterial-viral etiology. The work showed both the high sensitivity and specificity of the PCR method in the etiological diagnosis of AII. Among the examined patients, AII of viral origin prevailed (66.1%).

BackgroundXpert MTB/RIF (Xpert) was piloted in Kazakhstan to detect tuberculosis (TB) and rifampicin resistance (RR-)TB among individuals at risk of multidrug-resistant (MDR-) TB. This study assessed the performance of Xpert compared to conventional diagnostic methods, RR-TB case detection among various risk groups, treatment initiation and time to diagnosis and treatment.MethodsEligible individuals were tested with Xpert, smear microscopy, culture and drug-susceptibility testing (DST) at the national TB reference laboratory and three provincial laboratories. Data was collected prospectively from August 2012 to May 2013 from routine laboratory and treatment registers.ResultsA total of 5,611 Xpert tests were performed mostly targeting contacts of MDR-TB patients, ‘other’ presumptive MDR-TB patients, and retreatment cases (26%, 24% and 22%, respectively). Compared to phenotypic DST, the positive predictive value of Xpert to detect RR-TB was 93.1% and 96.4% and the negative predictive value was 94.6% and 92.7% using solid and liquid culture media, respectively. RR-TB detection was highest among (former) prisoners, retreatment cases, people living with HIV/AIDS (PLWHA), and TB patients with positive smears after intensive phase of treatment (59%, 58%, 54% and 53% among TB positives, respectively). 88.9% of RR-TB patients were registered to have started second-line TB treatment. Median time to diagnosis with Xpert was 0.0 days (IQR 0.0-1.0), time from diagnosis to start of first-line treatment 3.0 days (IQR 1.0-7.0), and to start of second-line treatment 7.0 days (IQR 4.0-16).ConclusionsCompared to conventional culture and DST, Xpert had a shorter result turn-around-time and excellent concordance to detect RR-TB. Time from sputum collection to start of second-line treatment was reduced to one week. The yield of Xpert could be maximized by increasing referrals from penitentiary and HIV centers to TB centers.

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