Digestion
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In pharmacokinetics, the Wagner-Nelson (W-N) method can accurately estimate the rate of drug absorption from its urinary elimination rate. A stable isotope (13C) breath test attempts to estimate the rate of absorption of 13C, as an index of gastric emptying rate, from the rate of pulmonary elimination of 13CO2. The time-gastric emptying curve determined by the breath test is quite different from that determined by scintigraphy or ultrasonography. In this report, we have shown that the W-N method can adjust the difference. ⋯ The W-N method can generate an accurate emptying flow curve from 13CO2 data, and it can adjust the difference between ultrasonography and the breath test.
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Randomized Controlled Trial Clinical Trial
Procaine hydrochloride fails to relieve pain in patients with acute pancreatitis.
Several analgesics are in use for pain control in patients with acute pancreatitis. Procaine hydrochloride (procaine) has a long tradition and is recommended by the German Society of Gastroenterology and Metabolic Diseases for pain treatment in patients with acute pancreatitis. There is no controlled trial showing that procaine could be effective for pain treatment. ⋯ Thus, intravenous procaine treatment is not effective for pain control in patients with acute pancreatitis.
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Using gentler endoscopes and improved sedation, great strides have been made in enhancing patients' comfort and acceptance of endoscopic procedures. Because morbidity and mortality have been associated with benzodiazepines in endoscopic sedation, safer alternatives were sought. Propofol (2,6-diisopropylphenol), a rapid and short-acting anesthetic, initially used in the 1980's for general anesthesia induction and maintenance, is a promising candidate. ⋯ Propofol's advantages over benzodiazepines and narcotics include a more rapid onset of action, full relief of discomfort and rapid recovery to alertness without residual sedative effects or anterograde amnesia, thereby making this drug a cost-effective and, with proper monitoring, safe choice.
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Comparative Study Clinical Trial
Multiple organ system failure in critically ill cirrhotic patients. A comparison of two multiple organ dysfunction/failure scoring systems.
The prognosis for critically ill cirrhotic patients depends on the extent of hepatic and extrahepatic organ dysfunction/failure. We hypothesize that a graded multiple organ dysfunction score, sequential organ failure assessment (SOFA), would provide more descriptive and discriminative power for predicting the hospital mortality for critically ill cirrhotic patients than the classical organ system failure (OSF) score, which defines organ failure as an all-or-none phenomenon. ⋯ Both OSF and SOFA scores are excellent tools for predicting prognosis for cirrhotic patients admitted to ICU. Both of them are superior to Child-Pugh score. Hospital mortality for critically ill cirrhotic patients occurs owing to severe failure of a relatively few organs, rather than because of an accumulation of mild dysfunction in many organ systems. Graded organ dysfunction scales provide no further benefit for predicting hospital mortality for critically ill cirrhotic patients.