Digestive diseases and sciences
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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.
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This study is to investigate the time-course expression of TLR2 and TLR4 on peripheral monocytes in patients receiving major abdominal surgical operation. ⋯ The expressions of TLR2 and TLR4 on monocytes were up-regulated during the early period after a major abdominal surgical operation in patients, which might be related to the activation of innate immunity.
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The purpose of this study was to analyze diagnostic yield of repeat computed tomography (CT) after negative initial CT versus yield of initial CT in patients presenting repeatedly to emergency room (ER) for nontraumatic abdominal pain. Medical costs and radiation exposure from repeat CT could be reduced if repeat CT after negative initial CT has a low diagnostic yield. ⋯ Repeat abdominal CT after initially negative CT(s) performed for nontraumatic abdominal pain has a low diagnostic yield. Leukocytosis and APACHE-II score might help predict CT scan positivity. Data suggest restricted abdominal CT utilization in ER patients with multiple prior negative CTs. Findings warrant confirmation in prospective studies.
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Cancer patients benefit from percutaneous endoscopic gastrostomy (PEG) in many ways including nutritional support and venting in cases of malignant obstruction. Lack of high-quality studies with adequate follow-up has led to limited information regarding risk stratification and predictors of morbidity and mortality. ⋯ Patients with high baseline illness severity are more likely to have complications and are at increased risk of mortality after PEG. Our study results suggest that particular attention be directed to ASA score, INR, WBC counts, transfusion requirements, presence of advanced malignancies, and the indication for PEG placement when determining risk of complications or death. Patients undergoing venting PEG are expected to have short post-PEG survival but improvement in quality of life likely justifies the risks associated with PEG placement.
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The prevalence of reflux esophagitis is increasing in Korea. Reflux esophagitis aggravates the stress and fatigue level of daily life, but less is known about the association with stress and fatigue, which could be bi-directional. ⋯ Reflux esophagitis is significantly associated with psychosocial stress, and the severity of reflux esophagitis correlates with the degree of stress.