The American journal of gastroenterology
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Am. J. Gastroenterol. · Jul 2009
Clinical TrialLow-dose propofol sedation for diagnostic esophagogastroduodenoscopy: results in 10,662 adults.
The use of propofol sedation during endoscopic procedures has increased in recent years. The aim of this study was to evaluate the safety and effectiveness of nurse-administered low-dose propofol sedation for diagnostic esophagogastroduodenoscopy (EGD). ⋯ Low-dose nurse-administered propofol sedation is safe and practical for diagnostic EGD.
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Am. J. Gastroenterol. · Jul 2009
Comparative StudyDisparities in emergency department wait times for acute gastrointestinal illnesses: results from the National Hospital Ambulatory Medical Care Survey, 1997-2006.
(i) The aims of this study were to report wait times for visits to US emergency departments (EDs) for acute gastrointestinal illnesses, (ii) to identify whether racial/ethnic disparities exist in wait times, and (iii) to characterize factors associated with delays in physician assessment. ⋯ A significant proportion of visits to US EDs for acute gastrointestinal illnesses are associated with a delay in initial clinical assessment. Hispanic patients waited longer and had a higher frequency of delays compared with other racial/ethnic groups. Future policies should be directed at reducing delays in physician assessment and addressing this healthcare disparity.
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Am. J. Gastroenterol. · Jul 2009
Comparative StudyEpistasis between Toll-like receptor-9 polymorphisms and variants in NOD2 and IL23R modulates susceptibility to Crohn's disease.
Recent data suggest functional interactions between NOD2 and other receptors of the innate immune system modulating inflammatory responses. Here we analyzed the role of Toll-like receptor 9 (TLR-9) gene variants with respect to susceptibility to inflammatory bowel disease (IBD) and tested for genetic interactions with NOD2 and other susceptibility genes for Crohn's disease (CD). ⋯ Our results provide evidence for genetic interactions between polymorphisms in TLR9 and CD-associated variants in NOD2, IL23R, and DLG5, differentially modulating CD susceptibility.
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Non-anesthesiologist-administered propfol (NAAP) sedation for endoscopic procedures remains controversial despite the overwhelming evidence that with proper training and patient selection, NAAP is safe and results in improved time to sedation and recovery when compared with standard sedation with a combination of an opioid and benzodiazepine. Emerging data suggest that NAAP also results in an improved psychomotor recovery. Can our patients return to meaningful tasks such as driving with NAAP after recovery in the endoscopy suite?