The American journal of gastroenterology
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Am. J. Gastroenterol. · Sep 2002
Comparative StudyHospital care for low-risk patients with acute, nonvariceal upper GI hemorrhage: a comparison of neighboring community and tertiary care centers.
The proportion of patients admitted to the hospital with acute upper GI hemorrhage (UGIH) who are at low risk for adverse outcomes may be substantial. The process of care for this low risk population likely varies across practice settings but has not been extensively studied. Use of the Rockall Risk score, a simple validated scoring index that predicts outcomes in UGIH, may help to identify these low risk patients. ⋯ In this study, the proportion of acute, low risk, nonvariceal, upper GI hemorrhage admissions to neighboring community and tertiary care medical centers was high, whereas adverse clinical outcomes in this group of patients was low. Use of healthcare resources seemed to be greater in the community hospital. This observed variation in the process of care for populations with similar disease severity and outcomes suggests an opportunity for evidence-based interventions aimed at improving the efficiency of care.
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Am. J. Gastroenterol. · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialSynergistic sedation with midazolam and propofol versus midazolam and pethidine in colonoscopies: a prospective, randomized study.
The aim of our study was to compare the safety and efficacy of the synergistic sedation with a low dose of midazolam combined with propofol versus the standard regimen of midazolam and pethidine for conscious sedation in colonoscopy in a group of patients that included a sufficient number of elderly patients with several comorbidities. ⋯ Our data suggest that the synergistic sedation with a low dose of midazolam combined with propofol was superior to a standard combination of midazolam and the opioid pethidine for colonoscopies as far as the patient comfort and recovery times are concerned.
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Am. J. Gastroenterol. · Jul 2002
ReviewAnabolic-androgenic steroids for alcoholic liver disease: a Cochrane review.
The objectives were to assess the beneficial and harmful effects of anabolic-androgenic steroids for alcoholic liver disease. ⋯ This systematic review could not demonstrate any significant beneficial effects of anabolic-androgenic steroids on any clinically important outcomes of patients with alcoholic liver disease.
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Am. J. Gastroenterol. · Jul 2002
Comparative StudyA new method for the quantification of neutrophil and eosinophil cationic proteins in feces: establishment of normal levels and clinical application in patients with inflammatory bowel disease.
The aims of this study were 1) to develop a valid method for the measurement of the eosinophil proteins eosinophil cationic protein (ECP) and eosinophil protein X (EPX) and neutrophil proteins myeloperoxidase and human neutrophil lipocalin (HNL) in feces and 2) to investigate their potential role as disease activity markers in inflammatory bowel disease (IBD). ⋯ The method described here takes into account the molecular properties of the granule proteins and the heterogeneity in feces consistency, which is a prerequisite for a valid and reproducible measurement of cationic granule proteins. We suggest that EPX and myeloperoxidase, when applied in IBD, are the best eosinophil and neutrophil markers for studying GI inflammation.