The American journal of gastroenterology
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Am. J. Gastroenterol. · Mar 2000
Review Case ReportsCompletion of upper endoscopic procedures despite paradoxical reaction to midazolam: a role for flumazenil?
Paradoxical excitation after benzodiazepine administration is well described. Although it is relatively uncommon, its occurrence can severely impede or even prevent the performance of upper endoscopy. We describe three cases in which paradoxical reactions to midazolam responded so well to flumazenil administration that the procedure was successfully completed in each instance. We review the limited literature on this topic and suggest that flumazenil may have greater utility in the management of this particular problem than is considered at present.
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Am. J. Gastroenterol. · Mar 2000
Increased urinary N-telopeptide cross-linked type 1 collagen predicts bone loss in patients with inflammatory bowel disease.
Reduced bone mineral density (BMD) is common in patients with inflammatory bowel disease (IBD), but the factors associated with its longitudinal rate of change have not been established. We prospectively assessed the rate of change in BMD, and its association with biochemical markers of bone turnover. ⋯ Spine and femoral neck bone loss continues over time in more than one-third of IBD patients. Increased NTx level predicts spinal bone loss in IBD patients.
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Am. J. Gastroenterol. · Mar 2000
Why are internal medicine residents at university medical centers not pursuing fellowship training in gastroenterology? A survey analysis.
The decrease in available GI fellowship positions appears to be associated with a disproportionate decrease in the quality of applicants. Thus, the aims of this study were: 1) to determine the current interest in advanced training of nonprimary care internal medicine residents at university medical centers, and 2) to identify the reasons why fellowship-bound residents are not pursuing GI. ⋯ The majority of residents at university training programs plan advanced training and want to pursue careers in academia, but not in GI/hepatology. Efforts to attract highly qualified residents to GI must emphasize the improved job market, especially as it exists in academia; must advertise research opportunities; and must de-emphasize the procedural nature of this subspecialty.
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Am. J. Gastroenterol. · Mar 2000
Letter Case ReportsAortoenteric fistula revisited: an endoscopic image.