Gastroenterology
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Randomized Controlled Trial Clinical Trial
Treatment of biliary colic with diclofenac: a randomized, double-blind, placebo-controlled study.
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used to relieve biliary colic. Follow-up was limited in previous studies, and the role of NSAIDs in the natural history of biliary colic has not been clarified. The purpose of this study was to evaluate the efficacy of diclofenac, a potent NSAID, in the the immediate symptomatic relief of biliary colic and the prevention of cholelithiasis-related complications. ⋯ In patients with cholelithiasis who present with biliary colic, a single 75-mg intramuscular dose of diclofenac can provide satisfactory pain relief and decrease substantially the rate of progression to acute cholecystitis.
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Three-dimensional (3D) ultrasound imaging of the total stomach volume has not yet been achieved. The aim of this study was to investigate whether a magnetic position sensor system for acquisition of 3D ultrasonograms could be used to determine gastric emptying rates and intragastric distribution. ⋯ This 3D ultrasound system using magnetic scanhead tracking showed excellent in vitro accuracy, calculated gastric emptying rates more precisely than by 2D ultrasound, and enabled estimation of intragastric distribution of a soup meal.
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Recently [111In-DTPA-D-Phe1]-octreotide was approved for somatostatin receptor scintigraphy (SRS) of gastroenteropancreatic tumors. SRS and other tumor localization methods can be time consuming, expensive, and involve patient inconvenience. The role of SRS in comparison to other tumor localization modalities remains undefined because the relative effects of these methods on management have not been studied. The aim of this study was to determine whether SRS alters clinical management in Zollinger-Ellison syndrome. ⋯ Because of the ability of SRS to alter clinical management combined with its superior sensitivity, high specificity, simplicity, and cost-effectiveness, SRS should be the initial imaging modality for patients with gastrinomas.
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Deglutitive glottal function during the preparatory phase of swallowing and its coordination with bolus transit during normal eating are important for airway protection. The aim of this study was to examine this coordination during consumption of a normal meal. ⋯ In more than half of the instances, during normal eating, food enters the pharynx during the preparatory phase before a swallow is initiated, the path of pharyngeal transit of solid bolus is different from that of liquid bolus, and the epiglottal edge appears to be the most sensitive trigger zone for swallowing.
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Increasing evidence shows that periodic screening by flexible sigmoidoscopy with appropriate referral of patients with adenomas to colonoscopy could substantially decrease colorectal cancer mortality rates. Estimates of the complete cost of such screening are needed. The aim of this study was to estimate the annual costs of periodic screening of Americans 50 years and older by flexible sigmoidoscopy with referral of subjects with adenomas to colonoscopy. ⋯ The cost of flexible sigmoidoscopy-based screening for colorectal cancer could vary as much as threefold depending on the protocol chosen.