The American journal of gastroenterology
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Propofol use for endoscopy is increasing rapidly. Its administration by registered nurses under the supervision of endoscopists has thus far proven safe, but is not realistically feasible in most U. ⋯ Transition to anesthetist-delivered sedation for endoscopy is being accompanied by increased costs, which in turn has the potential to adversely affect endoscopic practice. The gastroenterology and anesthesia communities should work together to explore mechanisms to expand propofol use or an alternative for endoscopy in a safe and cost-effective manner.
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Am. J. Gastroenterol. · Sep 2004
Comparative StudyAre physician-derived disease severity indices associated with health-related quality of life in patients with end-stage liver disease?
Model for end-stage liver disease (MELD) score is now often used as an overall indicator of health status for patients with end-stage liver disease. However, there are no data evaluating the associations between MELD scores and patient reports of health-related quality of life (HRQOL). ⋯ Despite objectively mild liver disease, the subjective HRQOL of this cohort was severely impaired. CTP score was more closely associated with patient-reported estimates of HRQOL than the MELD score. CTP or disease-specific HRQOL instruments may compliment MELD by providing insights into outcomes of importance to patients with low risk of mortality.
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Am. J. Gastroenterol. · Aug 2004
The role of pelvic floor dysfunction and slow colonic transit in adolescents with refractory constipation.
Although pelvic floor dysfunction (PFD) is recognized as a cause of refractory constipation in adults, this diagnosis is not frequently considered in children and adolescents with refractory constipation. The purpose of this study was to examine the symptoms and colonic transit in adolescents with constipation evaluated for a disorder in pelvic floor function. ⋯ Abnormal pelvic floor function and delayed colonic transit are demonstrable as single or combined problems in adolescents with refractory constipation.