Digestive diseases and sciences
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Inflammation of visceral structures in rats has been shown to produce visceral/somatic hyperalgesia. Our objectives were to determine if trinitrobenzene sulfonic acid (TNBS) induced colitis in rats leads to visceral/somatic hypersensitivity. Male Sprague-Dawley rats (200-250 g) were treated with 20 mg of TNBS in 50% ethanol (n = 40) or an equivalent volume of ethanol (n = 40) or saline (n = 25) via the colon. ⋯ TNBS-treated rats demonstrated somatic hypersensitivity at days 14-28 (P < 0.0001) in response to somatic stimuli of the hind paw. TNBS colitis is associated with visceral and somatic hypersensitivity in areas of somatotopic overlap. This model of colitis should allow further investigation into the mechanisms of visceral and somatic hypersensitivity.
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Randomized Controlled Trial Multicenter Study Comparative Study
Antidepressant therapy (imipramine and citalopram) for irritable bowel syndrome: a double-blind, randomized, placebo-controlled trial.
The efficacy of antidepressants in irritable bowel syndrome (IBS) is controversial. No trials have directly compared a tricyclic with a selective serotonin reuptake inhibitor. Our aim was to determine whether imipramine and citalopram are efficacious in IBS. ⋯ Neither imipramine nor citalopram significantly improved global IBS endpoints over placebo.
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Randomized Controlled Trial Comparative Study
Remifentanil compared with midazolam and pethidine sedation during colonoscopy: a prospective, randomized study.
The objective of our study was to compare the safety and efficacy of remifentanil during colonoscopy with those of the standard combination of midazolam and pethidine. ⋯ Remifentanil during colonoscopy provides sufficient pain relief with better hemodynamic stability, less respiratory depression, and significantly faster recovery and hospital discharge than moderate sedation with midazolam and pethidine.
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Pneumatosis intestinalis and gas within the portal venous system are findings predictive of bowel ischemia. The etiologies of these alarming radiographic signs are diverse and not all causes require emergent surgical intervention. The combination of pneumatosis intestinalis, portal venous gas, and acidosis typically portends bowel ischemia and inevitable necrosis. This case report is the first description of benign pneumatosis and portal venous gas secondary to irinotecan and cisplatin.
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Streptococcus bovis bacteremia has been linked to the presence of occult colon cancer since 1977. We present a case of pyogenic liver abscess and bacteremia with a different Streptococcus viridans 1 week after colonic adenocarcinoma was removed via polypectomy, discuss the likely etiology and review whether there is evidence to support looking for colon cancer in patients who present similarly but have not already undergone screening.