The American journal of gastroenterology
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Am. J. Gastroenterol. · Nov 2001
Review Case ReportsMushroom poisoning--from diarrhea to liver transplantation.
Mushroom poisoning from the genus Amanita is a medical emergency, with Amanita phalloides being the most common species. The typical symptoms of nausea, vomiting, abdominal pain, and diarrhea are nonspecific and can be mistaken for gastroenteritis. If not adequately treated, hepatic and renal failure may ensue within several days of ingestion. ⋯ Use of i.v. penicillin G is supported by most reports. Silibinin, although preferred over penicillin, is not easily available in the United States. In those with acute liver failure, liver transplantation can be life saving.
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Am. J. Gastroenterol. · Nov 2001
Comparative StudyFecal occult blood testing for colorectal cancer screening: use the finger.
Fecal occult blood testing (FOBT) has been widely underused as a means of colorectal cancer screening. Less than 35% of Americans have had the recommended FOBT in the last 5 yr. Guidelines suggest FOBT of three spontaneously passed stools (SPS) on a prescribed diet. Testing stool obtained by digital rectal exam (DRE) is discouraged because its yield in colorectal cancer screening is unknown. The aim of this study is to compare the positive predictive value of FOBT for the detection of colorectal neoplasia done by SPS versus DRE in asymptomatic outpatients. ⋯ The positive predictive value of FOBT on DRE for detecting neoplasia is similar to that of SPS in asymptomatic outpatients undergoing colorectal cancer screening. Positive FOBT on DRE warrants colonoscopic evaluation. Hemoccult testing by DRE may be performed in the office to increase patient compliance with colorectal cancer screening. A negative FOBT on DRE should be followed up with FOBT of SPS.