Digestive diseases and sciences
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Multicenter Study Observational Study
Characteristics and treatment of pyoderma gangrenosum in inflammatory bowel disease.
Pyoderma gangrenosum is a serious cutaneous complication seen in approximately 1 % of patients with inflammatory bowel disease (IBD). Oral corticosteroids are the mainstay treatment, although the evidence supporting their use is weak. ⋯ Oral corticosteroid therapy remains the most common treatment for pyoderma gangrenosum associated with inflammatory bowel disease. Biologic therapies such as infliximab and adalimumab should also be considered.
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Pain is common in patients with liver disease, difficult to treat, and poorly understood. ⋯ This large cohort study demonstrates the high prevalence of pain and opioid use in chronic liver disease. While disease variables contribute to pain, psychological symptoms were most strongly associated with pain and opioid use, providing rationale and target for therapeutic interventions.
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Both ulcerative colitis (UC) and diarrhea-predominant irritable bowel syndrome (IBS-D) are associated with alterations in enteric serotonin (5-HT) signaling. ⋯ Overexpression of S100A10 in the rectum may play a role in IBS as it is involved in modulating 5-HT1B receptors. The IL10-819 CC is a candidate genotype for both IBS and UC in Japanese.
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Randomized Controlled Trial
Influence of intraluminal acidification on esophageal secondary peristalsis in humans.
Secondary peristalsis contributes to clearance of retained refluxate or material from the esophagus. ⋯ Our data show that acute esophageal acid infusion enhances sensitivity of distension-induced secondary peristalsis and enhances secondary peristaltic activity. The study supports the evidence of the presence of acid-sensitive afferents in the modulation of distension-induced secondary peristalsis in humans.
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Effective and safe sedation for patients with liver cirrhosis is problematic. ⋯ Low-dose propofol sedation provided safe and effective sedation for EGD in cirrhotic patients with rapid recovery.