Device suitable for being ingested and associated system (assistance publique – hopitaux de paris) electricity nightcore lyrics

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In the case of the measurement of the gastric emptying time, the decrease of a marker from a meal phase, solid or liquid, is measured. The radio-pharmaceutical used is specific to the phase to mark. For example, to measure the gastric emptying of the digestible solid phase, it is possible to use an omelette in which the ovalbumin is marked in vitro by 40 MBq of technetium-rhenium sulphide whereas, to measure the gastric emptying of the liquid phase, it is possible to use a non-absorbable radiopharmaceutical, indium 111 (111In)-DTPA (5.5 MBq). The protocol is complex. It comprises several steps:

Double window acquisition (140 keV for 99mTc and 245 keV for 111In): anterior and posterior multistatic abdominal acquisitions each of 1 minute and separated by a rest interval of 13 minutes. The patient, in standing position at the moment the images are taken, can sit down during rest periods.

Plotting a region of interest (ROI) around the stomach, incidence by incidence and image by image; plotting of a paragastric ROI in such a way as to subtract the background noise from the untreated activity coming from the gastric region of interest.

The “Single marker-Single ingestion-Multiple films” method has been proposed by Arhan et al. (Arhan, P., et al., Segmental colonic transit time. Dis Colon Rectum, 1981. 24(8): p. 625-9): 20 radio-opaque markers are ingested in the morning and abdominal radiographies are carried out at 24 hour intervals up to elimination of all the markers.

A simplified version of the test (“Single ingestion-Single marker-Single film”) involves an abdominal radiography on the seventh day after the ingestion of the markers in order to determine not the colonic transit time, but the existence of a transit delay (Bouchoucha, M., et al., What is the meaning of colorectal transit time measurement? Dis Colon Rectum, 1992. 35(8): p. 773-82).

Another approach for the measurement of the total and segmental colonic transit (“Multiple markers-Multiple ingestions-Multiple films”), described by Metcalf et al. (Metcalf, A. M., et al., Simplified assessment of segmental colonic transit. Gastroenterology, 1987. 92(1): p. 40-7) and Chaussade et al. (Chaussade, S., et al., Mesure du temps de transit colique (TTC): description et validation d\’une nouvelle technique. Gastroenterol Clin Biol, 1986. 10(5): p. 385-9), involves the ingestion of different radio-opaque markers each day at the same time for 3 consecutive days. An abdominal radiography is taken at the ingestion time on the fourth day of the study, then at intervals of 3 days (7 days, 10 days, etc.) up to elimination of all the markers.

Today the measurement of the colonic transit time using radio-opaque markers is based on the hypothesis of a stable state during the measurement. In these conditions, the elimination of the markers takes place at the same speed whatever the day of ingestion (Bouchoucha, M., et al., What is the meaning of colorectal transit time measurement? Dis Colon Rectum, 1992. 35(8): p. 773-82). This method (“Single marker-Multiple ingestion-Single film”) makes it possible to measure the colonic transit time using a simple abdomen without preparation (AWP) on the lying down side, carried out after daily ingestion of 12 radio-opaque markers for 6 days (Bouchoucha, M., et al., What is the meaning of colorectal transit time measurement? Dis Colon Rectum, 1992. 35(8): p. 773-82). This “gold standard” makes it possible to determine oral-anal transit and segmental transit in the right colon, the left colon and the terminal bowel or rectosigmoid. This method, based on the hypothesis of a stable state, makes it possible to dispense with carrying out daily radiographies (Martelli, H., et al., Some parameters of large bowel motility in normal man. Gastroenterology, 1978. 75(4): p. 612-8; Martelli, H., et al., Mechanisms of idiopathic constipation: outlet obstruction. Gastroenterology, 1978. 75(4): p. 623-31) and markers of different types (Chaussade, S., et al., Mesure du temps de transit colique (TTC): description et validation d′une nouvelle technique. Gastroenterol Clin Biol, 1986. 10(5): p. 385-9).

These techniques may also be used to measure the gastric emptying time by defining the zone of interest by projection of the stomach (Bertrand J et al. Etude du temps d\’evacuation gastrique de repos normaux au moyen de granules radio-opaques. Applications cliniques et validation. Gastroenterol Clin Biol: 1980; 11; 4: 770-6).

However, the methods of using these systems require specific instrumentation and involve regular irradiation of the patient. They are thus cumbersome to implement and potentially dangerous to health on account of the level of irradiation to which the patient is subjected. Moreover, their precision is limited due to the importance of physiological variations (dietary intake, physical activity, stress, etc.). Moreover, the repetition of these examinations is limited due to the irradiation, which limits their interest in the evaluation of a treatment.

Furthermore, it is possible to monitor the ingestion of an ingested marker, of Smartpill™ or Motilis™ type, and to monitor its evolution in the digestive system. This marker may be detected by the positioning of a magnetic, Motilis™, or radiofrequency, Smartpill™, field emitted. Nevertheless, these markers do not enable monitoring representative of transit time, do not enable the measurement of segmental colonic transit and are sensitive to external perturbations thereby restricting their use in outpatient care.

The document US2009/009332 relates to a device that uses “RFID tags” (that is to say RFID markers) to evaluate the observance of the patient in a context of medication. In this patent application, the RFID tag is attached totally or partially to the medicine in solid form (hard capsule, tablet, etc.). Several tags may be used. The tag may be detected through the body of the patient by a system composed of one or more antennas. The medicine/tag “complex” is coated with one or more layers having the characteristic of disintegrating in the gastro-intestinal system. The intestinal absorption of the medicine and the pharmacological aim of this system do not allow its use with an aim of physiological exploration of colonic transit.

The document US2006/169292 relates to a system making it possible to detect within a human body a device that has been ingested, such as a capsule comprising a type of probe (pH, temperature, pressure, etc.), and referred to as intelligent. This device is active, because it benefits from batteries in order to be able to operate. RFID tags may be used and included in a capsule in order to monitor the movement of the capsule through the human body, which does not advance at the speed of the chyme. A single capsule is ingested by the patient. This system thus does not make it possible to assess the dispersion of an ingested bolus or to measure a total or segmental colonic transit time.