The American journal of gastroenterology
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Am. J. Gastroenterol. · Feb 2010
ReviewErrors in the conduct of systematic reviews of pharmacological interventions for irritable bowel syndrome.
Systematic reviews and meta-analyses are integral to evidence-based clinical decision making. Although flawed systematic reviews could compromise optimal decision making, their accuracy has received limited investigation. We assessed conduct of systematic reviews of pharmaceutical interventions for irritable bowel syndrome (IBS). ⋯ We found many errors in both application of eligibility criteria and dichotomous data extraction in the eight meta-analyses studied. Independent verification of systematic reviews and meta-analyses may be required for full confidence in their results.
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Am. J. Gastroenterol. · Feb 2010
Multicenter Study Controlled Clinical TrialDo stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls.
Despite a lack of supportive data, stool form and stool frequency are often used as clinical surrogates for gut transit in constipated patients. The aim of this study was to assess the correlation between stool characteristics (form and frequency) and gut transit in constipated and healthy adults. ⋯ Stool form predicts delayed vs. normal transit in adults. However, only a moderate correlation exists between stool form and measured whole-gut or colonic transit time in constipated adults. In contrast, stool frequency is a poor surrogate for transit, even in those with reduced stool frequency.
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Am. J. Gastroenterol. · Jan 2010
Review Meta AnalysisEmpiric quadruple vs. triple therapy for primary treatment of Helicobacter pylori infection: Systematic review and meta-analysis of efficacy and tolerability.
Recent treatment guidelines recommend two first-line therapies for Helicobacter pylori infection: proton pump inhibitor (PPI), bismuth, tetracycline, and metronidazole (quadruple therapy) or PPI, clarithromycin, and amoxicillin (triple therapy). We performed a systematic review and meta-analysis to compare the efficacy and tolerability of these regimens as first-line treatment of H. pylori. ⋯ Quadruple and triple therapies yielded similar eradication rates as primary therapy for H. pylori infection. Both therapies yielded suboptimal eradication rates. Patient compliance and side effects are similar for quadruple and triple therapies.
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Am. J. Gastroenterol. · Jan 2010
Classification of the severity of acute pancreatitis: how many categories make sense?
There is an ongoing effort to revise the 1992 Atlanta classification of acute pancreatitis in the light of emerging evidence. The categorization of the severity of acute pancreatitis is one of the key elements of the classification. This paper aims to define the optimal number of categories and provide their definitions on sound clinical grounds.
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Am. J. Gastroenterol. · Jan 2010
A population-based study of pyogenic liver abscesses in the United States: incidence, mortality, and temporal trends.
Few population-based studies have evaluated pyogenic liver abscess (PLA) in North America. We assessed the incidence of PLA and evaluated predictors of mortality. ⋯ The incidence of PLA is increasing and is associated with significant mortality that is attributable to several modifiable risk factors.