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regarding the use of regular medications during that time. Procedure Colonoscopy is usually performed on an outpatient basis. The patient is mildly sedated, the endoscope is inserted through the anus and moved gently around the bends of the colon. If a polyp is encountered, a thin wire snare is used to lasso it. Electrocautery (electrical heat) is applied to painlessly remove it. Other tests can be performed during colonoscopy, including biopsy to obtain a small tissue specimen for microscopic analysis. The procedure takes 15 to 30 minutes and is seldom remembered by the sedated patient. It is normal to experience mild cramping or abdominal pressure following the exam. This usually subsides in an hour or so. Alternative Testing Alternative tests to colonoscopy include a barium enema or other types of x-ray exams that outline the colon and allow a diagnosis to be made. Study of the stools and blood can provide indirect information about a colon condition. These exams, however, do not allow direct viewing of the colon, removal of polyps, or the completion of biopsies. Side Effects and Risks Bloating and distension typically occur for about an hour after the exam until the air is expelled. Serious risks with colonoscopy, however, are very uncommon. One such risk is excessive bleeding, especially with the removal of a large polyp. In rare instances, a tear in the lining of the colon can occur. These complications may require hospitalization and, rarely, surgery. Quite uncommonly a diagnostic error or oversight may occur. Due to the mild sedation, the patient should not drive or operate machinery following the exam. For this reason, someone should be available to drive the patient home.
Colonoscopy is the visual examination of the large intestine (colon) using a lighted, flexible fiberoptic or video endoscope. The colon begins in the rightlower abdomen and looks like a big question mark as it moves up and around the abdomen, ending in the rectum. It is 5 to 6 feet long. The colon has a number of functions including withdrawing water from the liquid stool that enters it so that a formed stool is produced. Reasons for examination Colon cancer -- a serious but highly curable malignancy Polyps -- fleshy tumors which usually are the forerunners of colon cancer Colitis (ulcerative or Crohn's) -- chronic, recurrent inflammation of the colon Diverticulosis and diverticulitis -- pockets along the intestinal wall that develop over time and can become infected Bleeding lesions -- bleeding may occur from different points in the colon Abdominal symptoms, such as pain or discomfort, particularly if associated with weight loss or anemia Abnormal barium x-ray exam Chronic diarrhea, constipation, or a change in bowel habits Anemia
Preparation To obtain the full benefits of the exam, the colon must be clean and free of stool. The patient receives instructions on how to do this. It involves drinking a solution which flushes the colon clean or taking laxatives and enemas. Usually the patient drinks only clear liquids and eats no food for the day before the exam. The physician advises the patient Source:
If the DNA types match. If a man does not match the child in two or more tests then it is usually accepted that he is not the true father of the child. no two people in the world have exactly the same genetic code. brother) of the biological father matching the child's DNA is much higher than that of a random man in the population. Results will not be affected by the storage of the specimens. By looking at a number of these variable regions in a person a DNA profile is produced. "Probability of Exclusion" = the chance that our testing would show at least one mismatch with the child (when the mother is tested) if the man is truly not the biological father of a child. Efficiency of the testing . Our testing provides a "probability of exclusion" of 99. DNA tests can still be performed. then he is not excluded as the father. Samples from the mother/child/alleged father can be collected at different times and places. as there is always a chance. DNA paternity testing is also often referred to simply as a DNA test. That figure is usually greater than 99. however remote. Reports for single parent testing may not be acceptable for legal or official purposes.98% (The National Association of Testing Authorities (NATA) requires the "probablity of exclusion" to be greater than 99. Every child inherits a unique mixture of DNA from its parents so.9%). DNA (Deoxyribonucleic Acid) is the body’s genetic 'blueprint'.DNA Testing If a man is not excluded as the father of a child. Cellmark became the UK's first private DNA paternity testing laboratory in 1987. It is a long thread-like molecule which carries the "genetic code" that determines our individual characteristics. The other half must therefore have been inherited from the child's biological father (paternal alleles). Without this information the chance of detecting that a nonfather is "excluded" is decreased.5%. child and alleged father should all be tested. he is excluded as the biological father. It was developed by Sir Alec Jeffreys at the University of Leicester in 1985. When the mother's profile is available it is possible to determine which half of the child's DNA was inherited from the mother. At each of these regions a person possesses two genetic types (known as alleles). however the results will be less informative than when both parents are tested. a paternity test or DNA testing.g. DNA is found in almost all of the billions of cells that make up our body.g. How is DNA used? Certain regions of human DNA show variations between people. (eg Family Court) Note: Single parent testing is only performed in exceptional circumstances. This is a relatively non-traumatic method that even very young babies (a few days old) can have samples taken in this way (although usually by heel/toe prick). By comparing the DNA profiles of the mother and child it is possible to determine which half of the child's DNA was inherited from its mother (maternal alleles). Who Needs to be Tested? The mother. except for identical twins. a "probability (or likelihood) of paternity" is reported. that another man in the population may have DNA types which match that child. Collection of Fingerprick Blood Samples All people being tested provide a fingerprick blood sample. one inherited from each parent. The possibility of a relative (e. The alleged father's profile is then examined to determine whether he has the DNA types in his profile that match the paternal alleles in the child. If the mother is not available. If the child is under 18 years of age. e. consent must be obtained from the child's mother (or legal guardian) before testing can be performed on a sample from the child. It is never possible to prove 100% that a man is definitely the biological father of a child. If the man's DNA types do not match the child's.
php . Security and Confidentiality All specimens are collected according to the Family Law Act 1975 Regulation (Amendments 1996). addresses and results. Issue of Reports Reports are issued by mail to the mother and the alleged father or their legal representative(s). A report will not be issued to the child unless specifically requested by both the mother and alleged father involved (appropriate forms are available from the VIFM on request). Specifications for labelling and sealing of sample containers All case details. Photocopies of these photograhs are included with the final reports.uk/faqs/q1.co.cellmark.vifm. Sources: o http://www.html o http://www. are strictly confidential. In this way. 45mm x 35mm) photographs that show a full face view of the donor's head and shoulders against a plain background. The person collecting the blood samples will ensure that these photographs are a good likeness of each client. Separate photographs must be provided for the mother. All samples and case files are stored in a secure area with tightly controlled access. including names.What to Take to the Appointment Two recent passport-sized (approx. No results will be issued over the phone. the identities of the people who were tested are recorded visually.org/paternity_gov. the child and the alleged father (these photographs cannot be returned). Reports are usually issued within 5 working days of receipt of all specimens. These include: o o strict requirements for photo identification of all people providing blood samples.
and lower esophageal sphincter hypotension and hypertension. stomach and duodenum. antireflux surgery. Patients must have nothing by mouth (npo) after midnight. and proximal jejunum. pneumatic dilation for achalasia). diffuse spasm. Esophageal manometry This test is used to evaluate patients with dysphagia. It measures the pressure in the upper and lower esophageal sphincters.Manometry Barostat: This is a pressure-sensing device that is placed in the stomach to measure gastric accommodation. o http://www. Anorectal manometry This test evaluates the anorectal sphincter mechanism and rectal sensation in patients with incontinence (and sometimes constipation) by means of a pressure transducer in the anus. Pressure is monitored for 5 to 24 h in both fasting and fed states. determines the effectiveness and coordination of propulsive movements. This device is used mainly in research studies assessing sensory threshold and altered visceral perception. transducers are placed in the gastric antrum. It can help diagnose Hirschsprung's disease and provide biofeedback training for fecal incontinence. duodenum.com/mmpe/sec02/ch009/ ch009e. Manometry is used in the esophagus. It also is used to evaluate esophageal function before certain therapeutic procedures (eg. complications are very rare. and detects abnormal contractions. The device consists of a plastic balloon and an electronic controller that varies the amount of air in the balloon to maintain constant pressure. and rectum. particularly in functional GI disorders. sphincter of Oddi. This test is used mainly in patients who have symptoms suggestive of dysmotility but normal gastric emptying studies. Aside from minor discomfort. systemic sclerosis. Manometry typically is done to evaluate motility disorders in patients in whom structural lesions have been ruled out by other studies. heartburn.merck.html Gastric analysis . It is done by passing a catheter containing solid-state or liquid-filled pressure transducers through the mouth or anus into the lumen of the organ to be studied. Gastroduodenal manometry In this test. or chest pain. Source: Manometry is measurement of pressure within various parts of the GI tract. Manometry is used to diagnose achalasia.
loss of appetite. a specimen is collected every 15 minutes for one hour. and their saliva must be ejected to avoid diluting the stomach contents. and volume. It is also utilized for suspected peptic ulcer. millimoles of H+ per liter. Purpose A gastric analysis is performed to evaluate gastric function by measuring the contents of a fasting patient's stomach for acidity. These abnormalities can be caused by a number of disorders. neither test is recommended for patients with esophageal problems. as the physician requests. Basal gastric acid secretion The patient should be fasting overnight (12 hours) prior to intubation. After 15 minutes. As is the case with the basal gastric secretion test. After allowing approximately 10 to 15 minutes for the patient to adjust to the presence of the tube. specimens are obtained every 15 minutes for a period of 90 minutes. and weight loss. The gastric acid output test is also not recommended in patients who are sensitive to pentagastrin (the drug used to stimulate gastric acid output). gastric acid stimulation. If pentagastrin is to be Gastric analysis consists of a series of tests used to analyze the contents of the stomach. appearance. The first two specimens are examined visibly for blood and volume but are discarded to eliminate gastric contents that might be affected by the stress of the intubation process. The patient is allowed no liquids during the test. or congestive heart failure. blood. whether performed for basal gastric acid secretion. the tube remains in place for the gastric acid stimulation test. but may have water up to one hour before the test.Because both the basal acid output test and the gastric acid stimulation test require gastric intubation through the mouth or nasal passage. Preparation The patient should be fasting (nothing to eat or drink after the evening meal) on the day prior to the test. alcohol. x rays and other studies are necessary to obtain a definitive diagnosis. and Zollinger-Ellison (Z-E) syndrome. cholinergics. Description This test. and gastric cancer. Precautions . bile. and saliva must be ejected to avoid diluting the stomach contents. aortic aneurysm. The gastric acid stimulation test is indicated when abnormalities are found during the basal secretion test. Pentagastrin. and with the patient in a sitting position. Antacids. While this test will detect abnormalities. is injected subcutaneously. The complete series involves: o o o o collecting residual gastric fluid from a fasting patient collecting basal secretions every 15 minutes for four hours intramuscular administration of a drug that stimulates gastric acid output collecting stomach secretions every 15 minutes for 90 minutes The appearance. severe gastric hemorrhage. volume. requires gastric intubation by mouth or through the nasal passage. adrenergic blockers. These specimens are called the post-stimulation specimens. millimoles of H+ per volume. pernicious anemia. The basal gastric secretion test is indicated for patients with obscure gastric pain. andadrenocorticosteroids should be withheld for one to three days before the test. including duodenal ulcer. H2-receptor antagonists. severe gastritis. Gastric acid stimulation test After the basal samples have been collected. or both. anticholinergics. the patient can have no liquids during this test. pH. and millimoles of H+ per hour of each specimen is then evaluated. or a similar drug that stimulates gastric acid output.
Source: o http://www. the patient may experience difficulty breathing or a coughing spell until the tube is properly inserted. Aftercare Such complications as nausea. entering the trachea instead of the esophagus. as well as psychological stress. The patient may also resume the usual diet and any medications that were withheld for the test(s). soothing lozenges may be given. dysrhythmias. esophageal perforation. there may be a transient rise in blood pressure. accurate testing requires that the patient be relaxed and isolated from all sources of sensory stimulation. Complications There is a slight risk that the gastric tube may be inserted improperly.healthline. Also. vomiting. If the patient has a sore throat.com/galecontent/gastr ic-analysis . Other complications may include bleeding. because the tube can be difficult to swallow. and abdominal distention or pain are possible following removal of the gastric tube. if a patient has an overactive gag reflex. as possible side effects may occur. Additionally. medical supervision should be maintained. can stimulate gastric secretion. because such external factors as the sight or odor of food. If this happens. layrngospasm and decreased mean pO2.administered for the gastric acid secretion test.
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