Digestive diseases and sciences
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Comparative Study Clinical Trial
Blinded prospective comparison of the performance of 22-gauge and 25-gauge needles in endoscopic ultrasound-guided fine needle aspiration of the pancreas and peri-pancreatic lesions.
Both 22- and 25-gauge needles are used for endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of lesions, yet limited data exist on whether either offers an advantage over the other in terms of specimen cellularity and quality. ⋯ Both FNA needles provided accurate diagnoses in all patients. There was no significant difference between the 22- and 25-gauge needle groups in the independent interpretation of two cytopathologists with respect to cellular yield and ability to render a diagnosis.
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To evaluate intravenous proton-pump inhibitor (IV PPI) prescribing in a single academic teaching hospital. ⋯ Intravenous PPI prescribing habits in this military hospital facility are poor. A multifaceted approach including physician/pharmacist education, IV PPI ordering templates, and a consensus medical position statement from a major gastroenterological or prominent medical association may lead to more appropriate use.
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Endoscopic findings and clinicopathologic characteristics of ischemic colitis: a report of 85 cases.
Ischemic colitis is the most common type of intestinal ischemia and has a clinical spectrum of injury that ranges from mild and transient ischemia to acute fulminant colitis. The aim of this study was to explore endoscopic findings and clinicopathologic characteristics of ischemic colitis and be accurate enough to avoid missed diagnosis or misdiagnosis. A retrospective analysis was undertaken of endoscopy findings and clinicopathologic characteristics of 85 cases of ischemic colitis from March 2005 to April 2008 in the endoscopy center of our hospital. ⋯ The mucosa of gangrenous colitis with cyanotic and pseudopolyps was endoscopically observed as well. Clinicopathologic characteristics showed mucosal inflammation accompanied by erosion, granulation tissue hyperplasia and gland atrophy, lamina propria hemorrhage, and macrophages with hemosiderin pigmentation in submucosa in particular. Although endoscopy findings and clinicopathologic characteristics of ischemic colitis are nonspecific, colonoscopy with biopsy plays a vital role in the early diagnosis of ischemic colitis.
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Randomized Controlled Trial
Efficacy of the standard quadruple therapy versus triple therapies containing proton pump inhibitor plus amoxicillin and clarithromycin or amoxicillin-clavulanic acid and metronidazole for Helicobacter pylori eradication in children.
Helicobacter pylori (H. pylori) cure rates vary in different geographical regions because of differences in hosts as well as in H. pylori strains. In this study we evaluated the efficacy of different treatment regimens for eradication of H. pylori infection in children, in order to select a treatment regimen that is most effective with the least adverse effects and cost. ⋯ Considering these data we suggest quadruple therapy as the first line of therapy for eradication of H. pylori infection in children in our geographic area (Iran).
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Although triggering receptor expressed on myeloid cells-1 (TREM-1) has recently been shown to be upregulated in the intestines of patients with inflammatory bowel disease (IBD), it remains unclear whether serum-soluble TREM-1 (sTREM-1) level reflects disease activity in patients with IBD. This study aimed to evaluate the correlation of sTREM-1 level with disease activity in IBD. We prospectively enrolled consecutive patients with IBD and assessed their clinical disease activity using the guidelines of the American College of Gastroenterology. ⋯ Moreover, sTREM-1 level correlated well with disease activity irrespective of disease extent. In patients with CD, sTREM-1 level was lower in those with remission compared with those without (46.8 +/- 35.3 pg/ml versus 77.8 +/- 43.1 pg/ml), but this trend did not reach statistical significance (P = 0.100). The results of our study suggest that sTREM-1 could be a potential marker for disease activity in IBD patients, especially those with UC.