Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Sep 2009
Randomized Controlled TrialPropofol alone versus propofol in combination with meperidine for sedation during colonoscopy.
Despite the increasing popularity of propofol for sedation in colonoscopy, the optimal regimen is still controversial. Both propofol alone and propofol in combination with meperidine are frequently used during colonoscopy, but the impact of adding meperidine has not been evaluated. This study aimed to investigate if adding meperidine to propofol offers any advantage in terms of patient tolerance, recovery time, and postcolonoscopy discomforts. ⋯ For sedated colonoscopy, propofol in combination with meperidine is better than propofol alone in improving patients' tolerance and recovery.
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J. Clin. Gastroenterol. · Aug 2009
Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population.
We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. ⋯ In an urban safety net healthcare population, among patients with established healthcare access and a scheduled gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient-related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access.
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J. Clin. Gastroenterol. · May 2009
Safety and efficacy of sorafenib in patients with advanced hepatocellular carcinoma in consideration of concomitant stage of liver cirrhosis.
The multikinase inhibitor sorafenib provides survival benefit for patients with advanced hepatocellular carcinoma (HCC) and liver cirrhosis (LCI) Child-Pugh A. We report our experiences with sorafenib in advanced HCC, particularly in patients with LCI Child-Pugh B/C, where only limited data are available in regard to safety and efficacy of sorafenib. ⋯ These data do not support the use of sorafenib in patients with LCI Child-Pugh C, and patients with LCI Child-Pugh B should be treated with caution until larger trials provide more safety data and a clinically relevant survival benefit under sorafenib therapy.
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J. Clin. Gastroenterol. · May 2009
A modified percutaneous transhepatic varices embolization with 2-octyl cyanoacrylate in the treatment of bleeding esophageal varices.
To evaluate the effect of a modified percutaneous transhepatic variceal embolization (PTVE) with 2-octyl cyanoacrylate (2-OCA) on the prevention and treatment of esophageal variceal bleeding. ⋯ The effect of PTVE with 2-OCA on esophageal varices is associated with the site and range of embolization. With the lower esophageal and periesophageal varices and/or the cardial submucosal and perforating vessels are sufficiently obliterated, PTVE with 2-OCA can improve long-term efficacy by preventing varices recurrence and rebleeding.