Virtual colonoscopy is as accurate as conventional colonoscopy in detecting colorectal cancers and pre-cancerous polyps, making it a viable alternative to more invasive cancer screening methods, according to recently released results of the National CT Colonography Trial.

The trial's lead author, Judy Yee, MD, chief of radiology at San Francisco VA Medical Center and professor and vice-chair of radiology at the University of California, San Francisco, says virtual (CT) colonoscopy requires no sedation, meaning patients return to normal activities quickly and with no loss of function. She hopes cost savings and increased patient satisfaction encourage more healthcare payors to cover the virtual screenings.

Dr. Yee's research team compared the test results of 2,531 patients aged 50 years and older who underwent both virtual and conventional colonoscopy on the same day. CT colonography identified adenomas across all patients with 84 percent accuracy and detected large suspicious growths on a per-patient basis with 90 percent accuracy. The researchers say these results are comparable to conventional colonoscopy. Overall, CT colonography identified 30 significant pre-cancerous lesions in 27 patients that were not detected by conventional colonoscopy, while missing one lesion found conventionally, say the researchers.

John L. Petrini, MD, FASGE, president of the American Society for Gastrointestinal Endoscopy, believes the results of the trial may increase the number of patients willing to undergo colonoscopy, but he raises concerns over CT colonography's failure to detect small lesions and the inconvenience - to both facility and patient - of scheduling a second colonoscopy to remove polyps detected during virtual screenings.

The results of the trial appear in the Sept. 18 issue of The New England Journal of Medicine, where a second study reports patients with no colorectal neoplasia detected during initial colonoscopy are at low risk for developing colorectal cancer.

The American Cancer Society and other guideline organizations call for colonoscopic screenings every 10 years, says lead author Thomas F. Imperiale, MD, of the Indiana University School of Medicine and Regenstrief Institute and a member of Indiana University's Melvin and Bren Simon Cancer Center. "Our study didn't assess whether the recommendation of 10 year screening interval for colonoscopy is 'right on' but we did determine that the appropriate screening interval can be more than five years for average risk individuals," he says. "Frankly, we don't know the optimal time interval between screenings."

Daniel Cook

While retained-sponge and -instrument errors happen about once in every 5,000 surgeries, counting discrepancies occur in one out of every eight cases - once for every 14 hours of operating time - according to researchers. In 59 percent of those discrepancies, a sponge, instrument or needle had been misplaced or lost.

The researchers' study, published in the August issue of the Annals of Surgery, was based on firsthand observation of 148 elective general surgeries in Boston-area hospitals, not staff reports of counting discrepancies.

They write that special attention must be given to counting sponges, which were involved in 45 percent of the counting discrepancies. "Improvements aimed at surgical sponges are likely to have the greatest impact," note the researchers. "Sponges predominate among malpractice claims."

Counting discrepancies are often associated with personnel changes. When a circulating nurse or surgery tech changed during a procedure, the likelihood of a counting discrepancy tripled, researchers found.

However, when both a nurse and a tech switched at the same time, the likelihood of a discrepancy stayed the same. The authors suggest limiting handoffs during surgery or coordinating handoffs so that the same team is present to count each time.

Kent Steinriede

A green dye that gives off bacteria-killing molecules when activated could help in battling the drug-resistant superbug MRSA, researchers announced at the Society for General Microbiology's autumn meeting in Dublin, Ireland.

The dye, called indocyanine green, is harmless to people but becomes toxic to bacteria when it's exposed to near-infrared light. Researchers led by Ghada Omar, MD, of University College London in Great Britain, found that the light-activated dye could kill 99 percent of methicillin-resistant Staphylococcus aureus in infected wounds. "The chemicals produced when the dye is activated harm the bacteria in such a wide variety of ways that it is unlikely bacteria could ever develop resistance to the treatment," says Dr. Omar. "This makes it ideal - and possibly the only option - for treating infections with multiple drug-resistant bacteria, including MRSA."

At the same meeting, researcher Lucia Caballero from Manchester Metropolitan University presented a report on a type of paint containing nanoparticles of titanium dioxide, which can help to kill bacteria on a healthcare facility's surfaces when exposed to ultraviolet light. "This would slow down contamination and save on the costs of cleaning maintenance," he told scientists, according to a news report.

Marc Siegel, an associate professor at New York University's School of Medicine, says that the bacteria-fighting technology is "very promising," but he warns that "it gets us away from the real issue, which is that we have a problem with cleanliness and sterility in hospitals."

Irene Tsikitas

Republican presidential candidate Sen. John McCain scored a decisive victory over Democratic contender Sen. Barack Obama in Outpatient Surgery Magazine's online straw poll last week. Of the 69 surgical facility managers who voted, 49 percent chose McCain and 42 percent chose Obama. Another 9 percent were undecided.

This week's question: In pediatric cases, can parents be present in the PACU when a child emerges from anesthesia at your facility? You'll find our Instapoll feature on the lower right hand side of our front page.

Dan O'Connor