|
1. |
About This Issue |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 181-181
Howard Spiro,
Preview
|
PDF (87KB)
|
|
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
2. |
EditorialGallstones and Upper Abdominal Discomfort |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 182-183
Nicholas Talley,
Preview
|
PDF (209KB)
|
|
摘要:
Many physicians consider gallstones to be a cause of vague upper abdominal discomfort. However, both dyspepsia and gallstones are common conditions in the general population, and the relationship between the two has continued to generate controversy. In this editorial, I review the evidence for and against a relationship between gallstones and dyspepsia. The data suggest that upper abdominal discomfort, heartburn, bloating, and other vague symptoms are not related to gallstones and the routine ordering of an ultrasound in the patient with dyspepsia is not warranted.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
3. |
Esophageal Dilation Can Be Done Safely Using Selective Fluoroscopy and Single Dilating Sessions |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 184-188
R. Kozarek,
D. Patterson,
T. Ball,
M. Gelfand,
G. Jiranek,
J. Bredfeldt,
J. Brandabur,
H. Wolfsen,
S. Raltz,
Preview
|
PDF (433KB)
|
|
摘要:
Maxims for safe esophageal dilation have included recommendations to use fluoroscopy in all instances and to limit dilation sessions to 2-mm increments. We reviewed a 34-month experience of all esophageal dilations undertaken at a large multispecialty clinic to define adherence to these recommendations and to delineate whether deviation was associated with significant complications. Four hundred thirty-two patients underwent 716 courses of esophageal dilation during this time, 92% of whom had benign disease. Eighty-nine percent of patients were dilated with polyvinyl dilators (Savary/American) and only 8% of these patients required fluoroscopic monitoring for the bougienage. Seventy-eight percent of the dilating sessions for patients without achalasia were undertaken using either a single large dilator (≥45 Fr) or employed incremental dilator sizes >2 mm (6 Fr) in a single session. There was a single perforation in 662 nonachalasia dilations and this was a consequence of attempted placement of an esophageal endoprosthesis. We conclude that use of guide wire technology and newer dilating techniques do away with the need for routine fluoroscopic control. Moreover, single large dilators or dilator increments >2 mm may be safely used, contingent on endoscopic stricture assessment.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
4. |
Endoscopic Intrasphincteric Injection of Botulinurn Toxin for the Treatment of Achalasia |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 189-191
Antonio Rollan,
Robinson Gonzalez,
Sergio Carvajal,
Jose Chianale,
Preview
|
PDF (236KB)
|
|
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
5. |
Comparative Trial of Pantoprazole and Ranitidine in the Treatment of Reflux EsophagitisResults of a German Multicenter Study |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 192-195
Herbert Koop,
Wolfgang Schepp,
Hans Dammann,
Andreas Schneider,
Reinhold Lühmann,
Meinhard Classen,
Preview
|
PDF (387KB)
|
|
摘要:
In 249 patients with acute symptomatic reflux esophagitis grade II and III (Savary-Miller classification), we compared the efficacy and safety of pantoprazole, a newly developed proton pump inhibitor given at a once-daily dose of 40 mg, with a standard dose of the H2receptor antagonist ranitidine (150 mg b.i.d.) in a randomized, double-blind, multicenter study. Complete healing was achieved after 4 and 8 weeks of therapy (protocol-correct) in 69 and 82% (pantoprazole) and 57 and 67% (ranitidine), respectively (p = 0.054 at 4 weeks and p < 0.01 at 8 weeks). The predominant symptoms of gastroesophageal reflux, i.e., heartburn and acid eructation, were more effectively reduced in pantoprazole- than in ranitidine-treated patients. The frequency of adverse events was low and did not differ between the two treatment groups. We conclude that pantoprazole is superior to ranitidine in the acute treatment of reflux esophagitis.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
6. |
Nonsteroidal Antiinflammatory Drugs Are Associated with Gastric Outlet Obstruction |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 196-198
Gary Weaver,
Rebecca Harper,
James Storey,
Paul Jenkins,
Nancy Merrell,
Preview
|
PDF (233KB)
|
|
摘要:
Nonsteroidal antiinflammatory drug associated gastric ulcerations are often prepyloric and painless; when recurrent, such ulcers may lead to pyloric scarring and gastric outlet obstruction. We performed a retrospective case control study to seek an association between gastric outlet obstruction and nonsteroidal antiinflammatory drug use. The use of nonsteroidal antiinflammatory drugs in cases with gastric outlet obstruction was compared to an age- and sex-matched outpatient control group undergoing endoscopy. The proportion of drug use by patients with gastric outlet obstruction, seven of nine, was significantly higher than the proportion in controls, 29 of 90. The duration of nonsteroidal antiinflammatory drug use was also significantly longer in patients with gastric outlet obstruction than in control patients. Chronic nonsteroidal antiinflammatory drug use is associated with gastric outlet obstruction.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
7. |
Can the Radiologist Recognize Helicobacter pylori Gastritis? |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 199-202
David Mond,
Rubem Pochaczevsky,
Frances Vernace,
Simmy Bank,
Ken Chow,
Preview
|
PDF (321KB)
|
|
摘要:
To evaluate radiologic findings ofHelicobacter pylori (H. pylori)in the upper gastrointestinal (UGI) tract, we retrospectively reviewed consecutive records of 676 symptomatic adults with gastric biopsies (224 positive) and 150 symptomatic adults with rapid urease tests (57 positive). All the UGI series of patients with positive biopsies or urease tests forH. pyloriwere compared with the UGI series of patients with negative urease tests. UGI examinations were evaluated blindly by two gastrointestinal radiologists without knowledge of clinical findings, original radiologic interpretations, or test results. They agreed that 8 of 18 (44%) UGIs of patients withH. pylorihad abnormally increased gastric folds in the fundus, body, or antrum as compared with none of 14 (0%) UGIs of patients withoutH. pylori(p < 0.01) (P.P.V. = 1.0). Inter-observer agreement was good (K = 0.63). Endoscopy in the eight patients with radiographic evidence of enlarged gastric folds all demonstrated marked abnormalities such as prominent gastric folds, gastric erythema, erosions, or peptic ulcers. Our findings indicate that enlarged gastric folds on the UGI series of a symptomatic adult are very suggestive of H. pylori gastritis.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
8. |
A Controlled Double Blind Multicenter Study of the Effectiveness of 5‐Aminosalicylic Acid in Patients with Crohn's Disease in Remission |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 203-206
Nadir Arber,
H. Odes,
Zvi Fireman,
Alexandra Lavie,
Efrat Broide,
Yoram Bujanover,
Stuart Becker,
Itamar Pomerantz,
Menachem Moshkowitz,
Jillian Patz,
Tuvia Gilat,
Preview
|
PDF (301KB)
|
|
摘要:
We evaluated the efficacy of an oral formulation of 5-amino-salicylic acid in lowering the relapse rate after remission of Crohn's disease. Included were 59 patients who had proven Crohn's disease of at least 1 year's duration, and who had been in continuous remission for at least 6 months, while taking only 5-aminosalicylic acid or no therapy at all. Remission was defined as a Harvey Bradshaw index score (Softley-Clamp modification) of <4. Patients were given coded mesalazine 250 mg or placebo tablets (2×2 day). They were seen at 0, 1, and 2 months, and then every 2 months until the end of the study. Trial endpoints were 1 year of follow-up, or clinical relapse results. After randomization, 31 patients were included in the placebo arm, and 28 in the treatment arm. There were no significant differences between the two groups at entry. Ten patients were withdrawn from the trial because of noncompliance, loss of follow-up, or headache. There were more clinical relapses in the placebo arm (15 patients, 55%) than in the treatment arm (6 patients, 27%) (p < 0.05). Mesalazine had a significant advantage over placebo (p < 0.05) only in the subgroups of patients with ileal Crohn's disease and in those older than 30 years. We conclude that mesalazine has a moderate but significant benefit in preventing relapse in Crohn's disease in remission; this occurred only in patients with small-bowel involvement or in those older than 30 years.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
9. |
Intravenous Cyclosporine for Steroid‐Refractory Attacks of Crohn's Disease |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 207-210
Javier Santos,
Juan Baudet,
Francesc Casellas,
Luisa Guarner,
Jaime Vilaseca,
Juan Malagelada,
Preview
|
PDF (347KB)
|
|
摘要:
A prospective, open trial was conducted to test whether i.v. cyclosporine was effective in the treatment of refractory Crohn's disease. Eight patients with acute steroid-refractory attacks were included. Intravenous cyclosporine, 5 mg/kg/day, was added to ongoing drug therapy. Patients who responded were then switched to oral cyclosporine for a mean 2.6-month period, and steroids were discontinued when possible. Six patients improved, with a mean latency time to onset of improvement of 9 days. Two did not improve, and both underwent urgent operation. On oral cyclosporine, five patients maintained remission and discontinued steroids, whereas one relapsed and underwent surgery. After discontinuation of oral cyclosporine, the five remaining patients relapsed, and two underwent surgery. One reversible episode of hepatobiliary toxicity and one of gastrointestinal intolerance were recorded. We conclude that i.v. cyclosporine effectively and rapidly induces improvement of acute steroid-refractory flare-ups of Crohn's disease, but after discontinuation relapse is to be expected.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
10. |
Colonic Transit in Soccer Players |
|
Journal of Clinical Gastroenterology,
Volume 20,
Issue 3,
1995,
Page 211-214
Bruno Sesboüé,
Pierre Arhan,
Ghislain Devroede,
Isabelle Lecointe-Besançon,
Patrick Congard,
Michel Bouchoucha,
Jacques Fabre,
Preview
|
PDF (352KB)
|
|
摘要:
To evaluate the effects of exercise on colonic function, we measured total and segmental transit times in 11 male soccer players and nine male radiology student technicians. Diet was kept constant in all subjects, who maintained their normal activities. For the soccer players, normal activities included 15 h of training and one match each week. Transit times were measured with radioopaque markers, using the multiple-ingestion, single-radiograph technique. No overall difference in large bowel transit was observed between the two groups. Right colon transit was considerably slower in the soccer players, whereas left colon and rectal transit were slightly accelerated. We conclude that an intensive sport activity only modifies regional differences in large bowel function. This may be of importance in extreme conditions, such as those experienced by marathon runners. Data should be obtained before prescribing exercise to treat constipation.
ISSN:0192-0790
出版商:OVID
年代:1995
数据来源: OVID
|
|