Endoscopic ultrasound criteria to predict the need for intervention in pancreatic necrosi…

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Intravenous Non-high-dose Pantoprazole is equally effective as High-dose Pantoprazole in …

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Value of fecal calprotectin in the evaluation of patients with abdominal discomfort: an o…

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The Frequency Of Microscopic And Focal Active Colitis In Patients With Irritable Bowel Syndrome.
BMC Gastroenterol. 2011 Aug 31;11(1):96
Authors: Ozdil K, Sahin A, Calhan T, Kahraman R, Nigdelioglu A, Akyuz U, Sokmen HM
…

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A prospective, multi center, randomized clinical study to compare the efficacy and safety of Ertapenem 3 days versus Ampicillin-Sulbactam 3 days in the treatment of localized community acquired intra-abdominal infections. (T.E.A. Study: Three …

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Polyethylene glycol vs. sodium phosphate for bowel preparation: A treatment arm meta-analysis of randomized controlled trials.
BMC Gastroenterol. 2011 Apr 14;11(1):38
Authors: Juluri R, Eckert G, Imperiale TF
ABSTRACT:…

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The role of endoscopy in the management of intestinal obstruction: a 20-year retrospective study.

BMC Gastroenterol. 2010 Nov 8;10(1):130

Authors: Katsanos KH, Maliouki M, Tatsioni A, Ignatiadou E, Christodoulou DK, Fatouros M, Tsianos EV

ABSTRACT: Purpose: The aim of the study was to assess the use colonoscopy over time in the assessment of large bowel obstruction in a tertiary university hospital. METHODS: Retrospective analysis of surgical and colonoscopy records for the years 1990-2009 in a university hospital. All patients diagnosed with non-conservatively managed bowel obstruction were included. RESULTS: We recorded 644 patients diagnosed with non-conservatively managed bowel obstruction. Four hundred forty-one (67.3%) were managed only by surgery, 157 (23.6%) were managed by colonoscopy, and 46 (6.9%) by combined colonoscopy and surgery. Patients over 77 years were more likely to receive colonoscopy as monotherapy or combined with surgery as compared to younger patients. Management by colonoscopy only and by combined colonoscopy and surgery increased over time. CONCLUSIONS: Colonoscopy in the management of non-conservatively treated bowel obstruction increased over time. However, therapeutic colonoscopy still has a limited role in bowel obstruction either as monotherapy or combined with surgery.

PMID: 21059218 [PubMed - as supplied by publisher]

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Management of patients with biliary sphincter of Oddi disorder without sphincter of Oddi manometry.

BMC Gastroenterol. 2010 Oct 22;10(1):124

Authors: Kalaitzakis E, Ambrose T, Phillips-Hughes J, Collier J, Chapman RW

ABSTRACT: Background The paucity of controlled data for the treatment of most biliary sphincter of Oddi disorder (SOD) types and the incomplete response to therapy seen in clinical practice and several trials has generated controversy as to the best course of management of these patients. In this observational study we aimed to assess the outcome of patients with biliary SOD managed without sphincter of Oddi manometry. Methods Fifty-nine patients with biliary SOD (14% type I, 51% type II, 35% type III) were prospectively enrolled. All patients with a dilated common bile duct were offered endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy whereas all others were offered medical treatment alone. Patients were followed up for a median of 15 months and were assessed clinically for response to treatment. Results At follow-up, 15.3% of patients reported complete symptom resolution, 59.3% improvement, 22% unchanged symptoms, and 3.4% deterioration. Fifty-one percent experienced symptom resolution/improvement on medical treatment only, 12% after sphincterotomy, and 10% after both medical treatment/sphincterotomy. Twenty percent experienced at least one recurrence of symptoms after initial response to medical and/or endoscopic treatment. Fifty ERCP procedures were performed in 24 patients with an 18% complication rate (16% post-ERCP pancreatitis). The majority of complications occurred in the first ERCP these patients had. Most complications were mild and treated conservatively. Age, gender, comorbidity, SOD type, dilated common bile duct, presence of intact gallbladder, or opiate use were not related to the effect of treatment at the end of follow-up (p>0.05 for all). Conclusions Patients with biliary SOD may be managed with a combination of endoscopic sphincterotomy (performed in those with dilated common bile duct) and medical therapy without manometry. The results of this approach with regards to symptomatic relief and ERCP complication rate are comparable to those previously published in the literature in cohorts of patients assessed by manometry.

PMID: 20969779 [PubMed - as supplied by publisher]

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Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy.

BMC Gastroenterol. 2010 Apr 15;10(1):37

Authors: Manfredini R, De Giorgio R, Smolensky MH, Boari B, Salmi R, Fabbri D, Contato E, Serra M, Barbara G, Stanghellini V, Corinaldesi R, Gallerani M

ABSTRACT: BACKGROUND: Previous studies have reported seasonal variation in peptic ulcer disease (PUD), but few large-scale, population-based studies have been conducted. METHODS: To verify whether a seasonal variation in cases of PUD (either compicated or not complicated) requiring acute hospitalization exists, we assessed the database of hospital admissions of the region Emilia Romagna (RER), Italy, obtained from the Center for Health Statistics, between January 1998 and December 2005. Admissions were categorized by sex, age (<65, 65-74, [greater than or equal to]75 yrs), site of PUD lesion (stomach or duodenum), main complication (hemorrhage or perforation), and final outcome (intended as fatal outcome: in-hospital death; nonfatal outcome: patient discharged alive). Temporal patterns in PUD admissions were assessed in two ways, considering a) total counts per single month and season, and b) prevalence proportion, such as the monthly prevalence of PUD admissions divided by the monthly prevalence of total hospital admissions, to assess if the temporal patterns in the raw data might be the consequence of seasonal and annual variations in hospital admissions per se in the region. For statistical analysis, the chi2 test for goodness of fit and inferential chronobiologic method (Cosinor and partial Fourier series) were used. RESULTS: Of the total sample of PUD patients (26,848 [16,795 males, age 65 +/- 16 yrs; 10,053 females, age 72 +/- 15 yrs, p<0.001)], 7,151 were <65 yrs of age, 8,849 between 65 and 74 yrs of age, and 10,848 [greater than or equal to]75 yrs of age. There were more cases of duodenal (DU). (89.8%) than gastric ulcer (GU) (3.6%), and there were 1,290 (4.8%) fatal events. Data by season showed a statistically difference with the lowest proportion of PUD hospital admissions in summer (23.3%) (p<0.001), for total cases and rather all subgroups. Chronobiological analysis identified three major peaks of PUD hospitalizations (September-October, January-February, and April-May) for the whole sample (p=0.035), and several subgroups, with nadir in July. Finally, analysis of the monthly prevalence proportions yielded a significant (p=0.025) biphasic pattern with a main peak in August-September-October, and a secondary one in January-February. CONCLUSIONS: A seasonal variation in PUD hospitalization, characterized by three peaks of higher incidence (Autumn, Winter, and Spring) is observed. When data corrected by monthly admission proportions are analyzed, late summer-autumn and winter are confirmed as higher risk periods. The underlying pathophysiologic mechanisms are unknown, and need further studies. In subjects at higher risk, certain periods of the year could deserve an appropriate chemopreventive effort to reduce the risk of PUD hospitalization.

PMID: 20398297 [PubMed - as supplied by publisher]

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