The American journal of gastroenterology
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Am. J. Gastroenterol. · Jun 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA randomized, double blind, dose-response comparison of balsalazide (6.75 g), balsalazide (2.25 g), and mesalamine (2.4 g) in the treatment of active, mild-to-moderate ulcerative colitis.
Balsalazide is a new innovative, mesalamine-containing prodrug that is activated by bacteria in the colon. Balsalazide has been shown previously to be well tolerated and effective in the treatment of acute ulcerative colitis. The aim of this study was to determine the dose-response of balsalazide for efficacy and safety in active, mild-to-moderate ulcerative colitis and to compare this profile with that of mesalamine, pH-dependent, delayed-release tablets. ⋯ Eight weeks of treatment with balsalazide (6.75 g daily) is significantly more effective than balsalazide (2.25 g daily) and more rapid in onset than mesalamine (2.4 g daily) in improving signs and symptoms of acute ulcerative colitis. Balsalazide (6.75 g daily) is well tolerated, and the safety profile does not differ from that of balsalazide (2.25 g daily) and mesalamine (2.4 g daily).
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Am. J. Gastroenterol. · Jun 2002
Review Case ReportsSpontaneous bacterial peritonitis caused by Streptococcus bovis: case series and review of the literature.
Streptococcus bovis is the rare cause of spontaneous bacterial peritonitis in decompensated cirrhosis. S. bovis bacteremia has long been known to be associated with colon cancer. We describe seven patients and review the seven previous reports of spontaneous bacterial peritonitis patients with S. bovis infection. ⋯ S. bovis is an infrequent cause of spontaneous bacterial peritonitis. The physician could make a case that colonoscopy is not needed because the patient is very sick and the possibility of GI pathology, especially colonic lesions, has been low. However, it may be that colonoscopy should be done if there are clinical suggestions to do so or the patient is well enough to withstand surgery.
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Am. J. Gastroenterol. · Jun 2002
Impact of physician specialty on the cost of nonvariceal upper GI bleeding care.
Upper GI bleeding (UGIB) is a common medical emergency that leads to a high consumption of medical resources and costs. We aimed to analyze the influence of physician specialty on the costs of nonvariceal UGIB care. ⋯ The implementation of specific evidence-based protocols by gastroenterologists reduces length of hospital stay and saves medical costs in patients with nonvariceal UGIB, especially those at low risk.
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Am. J. Gastroenterol. · May 2002
Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases.
Propofol has certain advantages over benzodiazepines plus narcotics as sedation for endoscopy. In a few centers, propofol has reportedly been used in endoscopic procedures and administered by nurses supervised by gastroenterologists without attendance by anesthesiologists or nurse anesthetists. ⋯ Propofol can be given safely by appropriately trained nurses under supervision by endoscopists. Technology that allows immediate detection of apnea would likely further improve its safety.