Journal of clinical gastroenterology
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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.
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J. Clin. Gastroenterol. · May 2010
Randomized Controlled Trial Multicenter Study Comparative StudyA randomized, double-blind, phase 3 study of fospropofol disodium for sedation during colonoscopy.
This double-blind, multicenter study evaluated the safety and efficacy of intravenous fospropofol (6.5 mg/kg vs. 2 mg/kg) for moderate sedation in patients undergoing colonoscopy. ⋯ The fospropofol 6.5-mg/kg dosing regimen was well tolerated and effective for sedation during colonoscopy and was associated with higher rates of sedation success, memory retention, and physician satisfaction than the fospropofol 2-mg/kg dose.
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J. Clin. Gastroenterol. · May 2010
Controlled Clinical TrialBezafibrate treatment of primary biliary cirrhosis following incomplete response to ursodeoxycholic acid.
Ursodeoxycholic acid (UDCA) is the only current pharmacologic treatment for primary biliary cirrhosis (PBC). However, some patients show persistent liver biochemical abnormalities even after 6 to 12 months treatment. Bezafibrate retard is a commonly used medication for hyperlipidemia. In Japanese studies, it was found to lower liver enzyme levels, apparently through its action on multiple drug resistance gene 3, a transport element of the ATP-dependent bile secretion system, and on peroxisome proliferator-activated receptor-alpha. The aim of this study was to evaluate the effect of adding bezafibrate to the treatment regimen in patients with PBC and a partial response to UDCA. ⋯ Combination therapy with bezafibrate and UDCA improves the biochemical profile of patients with PBC who respond only partially to UDCA. A larger controlled study is needed to evaluate the clinical implications of these findings.
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J. Clin. Gastroenterol. · Apr 2010
Differential diagnosis for intrahepatic biliary cystadenoma and hepatic simple cyst: significance of cystic fluid analysis and radiologic findings.
This study evaluated the significance of cystic fluid analysis and radiologic findings in the differential diagnosis of biliary cystadenomas (BCA) and hepatic simple cysts (HSCs). ⋯ Cystic fluid carbohydrate antigen 19-9 levels and carcinoembryonic antigen levels were not useful for differential diagnosis of BCA vs. HSC. BCA were more common than HSCs in females, patients with a septum, and patients with septal thickening.
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J. Clin. Gastroenterol. · Apr 2010
Randomized Controlled Trial Comparative StudyTen and eight-day sequential therapy in comparison to standard triple therapy for eradicating Helicobacter pylori infection: a randomized controlled study on efficacy and tolerability.
Sequential therapy (SQT) is effective in the eradication of Helicobacter pylori and could become an alternative to standard triple therapy (STT). ⋯ This study shows that SQT, for 8 or 10 days, is well tolerated and highly effective in H. pylori eradication and could represent a valid alternative to STT. Further studies, with more power, on larger populations and from other countries are necessary to validate the present findings.