The American journal of gastroenterology
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Am. J. Gastroenterol. · Dec 2010
Editorial CommentEditorial: Neurolysis for pancreatic cancer pain: same song, different verse?
Since Kappis first performed percutaneous neurolysis in 1914, investigators have employed innumerable technical variations in an effort to enhance the efficacy. Similar efforts have been underway by endosonographers since Wiersema performed the first endoscopic ultrasound (EUS)-guided celiac plexus neurolysis in 1996. ⋯ Sakamoto et al. present a new method of EUS-guided neurolysis in an attempt to improve the outcomes. Although their data are promising, we eagerly await rigorously designed studies that may validate their findings.
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Am. J. Gastroenterol. · Dec 2010
Editorial CommentEditorial: Detection of small polyps: much ado about nothing?
Computed tomographic (CT) colonography (CTC) represents an alternative to optical colonoscopy for colorectal cancer screening. However, diminutive polyps (≤ 5 mm) are not routinely reported for CTC. ⋯ Although the study was not randomized, the results highlight the difference between the two screening strategies. Because of incomplete understanding of the natural history of diminutive adenomas, further study is needed to determine the long-term impact of the use of CTC for colorectal cancer screening.
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Am. J. Gastroenterol. · Nov 2010
The impact of videorecording on the quality of colonoscopy performance: a pilot study.
Colonoscopy provides imperfect protection against colorectal cancer and is operator dependent. Colonoscopies typically are poorly documented. We aimed to determine whether videorecording impacts short-term performance of colonoscopy. ⋯ Awareness of videorecording improved physician performance of colonoscopy. Further investigation of the role of videorecording in achieving sustained improvements in the quality performance of colonoscopy, including increases in adenoma detection, is warranted.
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Immunological and guaiac-based fecal occult blood tests (iFOBTs and gFOBTs) are widely used for early detection of colorectal cancer (CRC). We aimed to assess potential sex differences in performance of iFOBTs and gFOBT in the screening setting. ⋯ There are major sex differences in the performance of fecal occult blood testing, which might require careful attention in the interpretation of test results, and in the design, modeling, and evaluation of CRC screening strategies.
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Am. J. Gastroenterol. · Oct 2010
Randomized Controlled Trial Multicenter Study Clinical TrialPancrelipase delayed-release capsules (CREON) for exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery: A double-blind randomized trial.
Pancreatic-enzyme replacement therapy (PERT) is the standard of care to prevent maldigestion, malnutrition, and excessive weight loss in patients with exocrine pancreatic insufficiency (EPI) due to chronic pancreatitis (CP) or pancreatic surgery (PS). Our objective was to assess the efficacy and safety of a new formulation of pancrelipase (pancreatin) delayed-release 12,000-lipase unit capsules (CREON) in patients with EPI due to CP or PS. ⋯ Pancrelipase delayed-release 12,000-lipase unit capsules were effective in treating fat and nitrogen maldigestion with a TEAE rate similar to that of placebo in patients with EPI due to CP or PS.