World J Gastroentero
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World J Gastroentero · Dec 2006
Editorial ReviewBrain edema and intracranial hypertension in fulminant hepatic failure: pathophysiology and management.
Intracranial hypertension is a major cause of morbidity and mortality of patients suffering from fulminant hepatic failure. The etiology of this intracranial hypertension is not fully determined, and is probably multifactorial, combining a cytotoxic brain edema due to the astrocytic accumulation of glutamine, and an increase in cerebral blood volume and cerebral blood flow, in part due to inflammation, to glutamine and to toxic products of the diseased liver. Validated methods to control intracranial hypertension in fulminant hepatic failure patients mainly include mannitol, hypertonic saline, indomethacin, thiopental, and hyperventilation. ⋯ Artificial liver support systems have been under investigation for many decades. The bioartificial liver, based on both detoxification and swine liver cells, has shown some efficacy on reduction of intracranial pressure but did not show survival benefit in a controlled, randomized study. The Molecular Adsorbents Recirculating System has shown some efficacy in decreasing intracranial pressure in an animal model of liver failure, but has still to be evaluated in a phase III trial.
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World J Gastroentero · Dec 2006
Randomized Controlled TrialListening to Turkish classical music decreases patients' anxiety, pain, dissatisfaction and the dose of sedative and analgesic drugs during colonoscopy: a prospective randomized controlled trial.
To determine whether listening to music decreases the requirement for dosages of sedative drugs, patients' anxiety, pain and dissatisfaction feelings during colonoscopy and makes the procedure more comfortable and acceptable. ⋯ Listening to music during colonoscopy helps reduce the dose of sedative medications, as well as patients' anxiety, pain, dissatisfaction during the procedure. Therefore, we believe that listening to music can play an adjunctive role to sedation in colonoscopy. It is a simple, inexpensive way to improve patients' comfort during the procedure.
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Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. This is believed to be a behavioral disorder because there are no associated morphological or neurological abnormalities, and consequently biofeedback training has been recommended for treatment. Biofeedback involves the use of pressure measurements or averaged electromyographic activity within the anal canal to teach patients how to relax pelvic floor muscles when straining to defecate. ⋯ Moreover, its effectiveness is specific to patients who have dyssynergic defecation and not slow transit constipation. However, in children, no clear superiority for biofeedback compared to laxatives has been demonstrated. Based on three randomized controlled studies in the last two years, biofeedback appears to be the preferred treatment for dyssynergic defecation in adults.
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World J Gastroentero · Nov 2006
Medical malpractice litigation related to gastrointestinal endoscopy in Japan: a two-decade review of civil court cases.
To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. ⋯ These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists.
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World J Gastroentero · Nov 2006
Can albumin administration relieve lung injury in trauma/hemorrhagic shock?
To study the effect of albumin administration on lung injury in trauma/hemorrhagic shock (T/HS). ⋯ The infusion of albumin during resuscitation period can protect lung from injury and decrease the expressions of CD11b/CD18, ICAM-1 in T/HS rats.