Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Oct 2006
Prospective evaluation of the use and outcome of admission stool guaiac testing: the Digital Rectal Examination on Admission to the Medical Service (DREAMS) Study.
Although physicians often perform fecal occult blood testing at the time of hospital admission, the practice of admission stool guaiac (ASG) testing has not been evaluated prospectively. The aim of this study was to determine the frequency and outcomes of digital rectal examination (DRE) and ASG testing in patients admitted to the hospital. ⋯ Although DRE and ASG testing are commonly performed on admission to the hospital, documentation of the findings and follow-up of positive tests are poor. These findings highlight the need to improve physician training on the appropriate use and documentation of the DRE and fecal occult blood testing.
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J. Clin. Gastroenterol. · Oct 2006
Endoscopic techniques and management of foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: a retrospective analysis of 139 cases.
Ingested foreign bodies and food bolus impaction are frequently seen in endoscopic practice. Successful foreign body and food bolus removal may depend on the method used, the choice of device, and the experience level of the endoscopist, although few papers report experience and outcome of tertiary centers. ⋯ Endoscopic removal of upper gastrointestinal tract foreign bodies and food bolus impaction is efficacious and safe. Especially the Roth net is the best device for safe retrieval of food boluses and button disc batteries.
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J. Clin. Gastroenterol. · Oct 2006
Different autonomic responses to experimental pain in IBS patients and healthy controls.
Pain perception ratings in irritable bowel syndrome (IBS) patients suggest that they present either hypoalgesia or hyperalgesia. However, little is known about the physiologic responses these patients present to a somatic painful stimulus. ⋯ For comparable pain perception, IBS subject demonstrated different autonomic nervous system response to pain, which supports the view of autonomic dysregulation in IBS.
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J. Clin. Gastroenterol. · Oct 2006
Management of intraductal papillary-mucinous neoplasm of the pancreas: treatment strategy based on morphologic classification.
The aim of this study was to examine and clarify the preoperative markers that are useful for differentiating between benign and malignant lesions of intraductal papillary-mucinous neoplasms (IPMN) of the pancreas, grouped according to morphologic classification. ⋯ The incidence of malignant lesions was extremely high in main duct type IPMN, indicating that surgery is required in all these patients. However, to determine whether surgery is indicated in branch duct type IPMN it is necessary to obtain an appropriate image diagnosis focusing on main duct diameter and mural nodules and also to carry out cytology and measurement of telomerase activity in samples of pancreatic juice.