The American journal of gastroenterology
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Am. J. Gastroenterol. · Nov 2005
Randomized Controlled Trial Comparative StudyUrgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial.
We hypothesized that early intervention in patients with lower gastrointestinal bleeding (LGIB) would improve outcomes and therefore conducted a prospective randomized study comparing urgent colonoscopy to standard care. ⋯ Although urgent colonoscopy identified a definite source of LGIB more often than a standard care algorithm based on angiography and expectant colonoscopy, the approaches are not significantly different with regard to important outcomes. Thus, decisions concerning care for patients with acute LGIB should be based on individual experience and local expertise.
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Am. J. Gastroenterol. · Nov 2005
The journal impact factor as a predictor of trial quality and outcomes: cohort study of hepatobiliary randomized clinical trials.
To examine the association between the impact factor and characteristics of hepatobiliary randomized clinical trials. ⋯ The present study supports the use of the impact factor as a rough quality indicator. However, even trials in high impact journals may be small or may have inadequate quality. Critical appraisal of individual trials is always necessary, irrespective of the place of publication.
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Am. J. Gastroenterol. · Nov 2005
Small gallstones are associated with increased risk of acute pancreatitis: potential benefits of prophylactic cholecystectomy?
Pancreatitis is a severe complication of gallstone disease with considerable mortality. Small gallstones may increase the risk of pancreatitis. Our aims were to evaluate potential association of small stones with pancreatitis and potential beneficial effects of prophylactic cholecystectomy. ⋯ Small gallstones are associated with pancreatitis. Prophylactic cholecystectomy may lead to gain or loss of life-years in patients with small stones, depending on incidence and mortality of pancreatitis.
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Am. J. Gastroenterol. · Nov 2005
Review Meta AnalysisMilk thistle for alcoholic and/or hepatitis B or C liver diseases--a systematic cochrane hepato-biliary group review with meta-analyses of randomized clinical trials.
Our objectives were to assess the beneficial and harmful effects of milk thistle (MT) or MT constituents versus placebo or no intervention in patients with alcoholic liver disease and/or hepatitis B and/or C liver diseases. ⋯ Based on high-quality trials, MT does not seem to significantly influence the course of patients with alcoholic and/or hepatitis B or C liver diseases. MT could potentially affect liver injury. Adequately conducted randomized clinical trials on MT versus placebo may be needed.
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Am. J. Gastroenterol. · Nov 2005
Randomized Controlled Trial Multicenter Study Comparative StudyIntravenous iron sucrose versus oral iron supplementation for the treatment of iron deficiency anemia in patients with inflammatory bowel disease--a randomized, controlled, open-label, multicenter study.
Anemia is a frequent complication in patients with inflammatory bowel disease (IBD). The optimal route for iron supplementation to replenish iron stores has not been determined so far. We therefore evaluated the efficacy and safety of intravenous iron sucrose as compared with oral iron sulfate for the treatment of iron deficiency anemia (IDA) in patients with IBD. ⋯ Although being equal in short-term efficacy and overall tolerability our results suggest a better gastrointestinal tolerability for iron sucrose. Larger trials are mandatory to prove a possible advantage of iron sucrose in short- and long-term efficacy as well as in tolerability over iron sulfate in the management of IDA in IBD.