Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Aug 2010
Randomized Controlled Trial Comparative StudyA full solid diet as the initial meal in mild acute pancreatitis is safe and result in a shorter length of hospitalization: results from a prospective, randomized, controlled, double-blind clinical trial.
To compare the safety and length of hospitalization (LOH) between a full solid diet as the initial meal for refeeding after mild acute pancreatitis (AP) as compared with 2 other diets. ⋯ Oral refeeding with a full solid diet in mild AP was well tolerated and resulted in a shorter LOH in patients without abdominal pain relapse.
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J. Clin. Gastroenterol. · Aug 2010
Case ReportsCoexisting hepatopulmonary syndrome and portopulmonary hypertension: implications for liver transplantation.
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) represent pulmonary complications of liver disease and portal hypertension. The underlying pathophysiology behind these entities is complex and involves different effects of vasoactive substances on the pulmonary vasculature, among them endothelin-1 and nitric oxide (NO). Hepatopulmonary syndrome results from vasodilation, intrapulmonary shunting, and hypoxia. ⋯ We present a case report in which these 2 processes with opposing pathologic mechanisms coexist in the same patient. We also conducted a literature search to identify other documented cases of coexisting hepatopulmonary syndrome and portopulmonary hypertension, common clinical features of these patients, and outcomes with or without treatment. Our case highlights the importance of recognizing the coexistence of these 2 disease processes, as they may occur simultaneously and affect the approach to treatment, including liver transplantation.
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It is imperative that responsible clinicians understand the relationship between computed tomography imaging and radiation-induced malignancy risk. As the concept of computed tomography-induced malignancy risk becomes more widespread, it is important that clinicians are well informed and are able to intelligently answer questions and concerns posed by their patients and are able to understand and discuss the issues with their radiologist colleagues. The purpose of this article is to review the history of ionizing radiation exposure growth in diagnostic imaging, to understand the biologic effects of radiation exposure, to define the growth of ionizing radiation from computed tomography in the United States, and to explore available mechanisms that can be used to control excessive patient radiation exposure.