Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
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Clin. Gastroenterol. Hepatol. · Nov 2009
Early systemic inflammatory response syndrome is associated with severe acute pancreatitis.
There have been few clinical studies of systemic inflammatory response syndrome (SIRS) in patients with acute pancreatitis. The aim of this study was to evaluate the role of SIRS in assessing severity of acute pancreatitis. ⋯ The majority of patients hospitalized with acute pancreatitis have SIRS on day 1. The severity of acute pancreatitis is greater among patients with SIRS on day 1 and, in particular, among those with 3 or 4 SIRS criteria, compared with those without SIRS on day 1.
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Clin. Gastroenterol. Hepatol. · Oct 2009
Randomized Controlled Trial Comparative StudyA randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation.
After 5 years of intensive oral laxative use, up to 30% of constipated children still have an unsuccessful outcome. Children refractory to oral laxatives might benefit from regular rectal evacuation by enemas. This randomized controlled trial compared the effects of additional treatment with rectal enemas (intervention) with conventional treatment alone (oral laxatives, control) in severely constipated children. ⋯ There is no additional effect of enemas compared with oral laxatives alone as maintenance therapy for severely constipated children.
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Clin. Gastroenterol. Hepatol. · Oct 2009
A community-based survey of abdominal pain prevalence, characteristics, and health care use among children.
Abdominal pain is a common clinical problem among children and adolescents and an important public health problem. The German Health Interview and Examination Survey for Children and Adolescents was performed to assess children's health and living conditions in a representative population sample. By using data collected from this survey, we evaluated the prevalence and characteristics of abdominal pain and assessed health care use. ⋯ High levels of prevalence and health care use reveal that abdominal pain is an important public health problem in children and adolescents. Abdominal pain in children is influenced by a variety of biopsychosocial factors.
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Clin. Gastroenterol. Hepatol. · Sep 2009
Comparative StudySeverity of organ failure is an independent predictor of intracranial hypertension in acute liver failure.
Ionized ammonia (NH(3)) and partial pressure of the gaseous ammonia (pNH(3)) are associated with hepatic encephalopathy and intracranial hypertension in patients with acute liver failure; NH(3) is also believed to contribute to extrahepatic organ failure. We investigated whether the severity of organ failure was associated with intracranial hypertension and evaluated the correlation between NH(3) and pNH(3) and grade of hepatic encephalopathy. ⋯ SOFA score and ammonia levels are independent predictors of intracranial hypertension. In patients with acute liver failure admitted to the intensive care unit, pNH(3) level is a better predictor of clinical grade of hepatic encephalopathy than arterial NH(3) level.