European journal of gastroenterology & hepatology
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Eur J Gastroenterol Hepatol · Nov 2007
Case ReportsLiver transplantation for nonsteroidal anti-inflammatory drug-induced liver failure: nimesulide as the first implicated compound.
Among industrialized countries, the rate of drug-induced liver failure varies widely accounting for about 1-12% of the indications for liver transplantation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are with antibiotics the most frequently involved compounds. In this single-center series of 57 consecutive cases of acute liver failure treated by orthotopic liver transplantation, five were related to NSAIDs-induced liver damage, three being due to nimesulide use. This has to be taken as a further warning about the potential for this compound to induce liver failure.
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Eur J Gastroenterol Hepatol · Nov 2007
Randomized Controlled TrialConscious sedation during endoscopic retrograde cholangiopancreatography: midazolam or midazolam plus meperidine?
No consensus exists for the safest and most effective agent and for optimal drug doses for sedation during endoscopic retrograde cholangiopancreatography (ERCP). We aimed to compare the efficacy of midazolam with that of midazolam+meperidine, which provided comfort for the patient during ERCP. ⋯ Conscious sedation for ERCP can be successfully and safely achieved by using either only midazolam or a low dose of midazolam with meperidine. Adding of meperidine to midazolam resulted in better patient and endoscopist comfort.
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Eur J Gastroenterol Hepatol · Nov 2007
Meta AnalysisSuspected choledocholithiasis: endoscopic ultrasound or magnetic resonance cholangio-pancreatography? A systematic review.
There is a lack of consensus on the optimal noninvasive strategy for patients with suspected choledocholithiasis after a negative transabdominal ultrasound and/or computed tomography. A meta-analysis was conducted to compare the diagnostic ability of endoscopic ultrasound (EUS) and magnetic resonance cholangio-pancreatography (MRCP) in patients with suspected common bile duct (CBD) stones. ⋯ The analysis demonstrated that, with respect to sensitivity, specificity and accuracy, there was no statistically significant difference between EUS and MRCP for the detection of choledocholithiasis. Our meta-analysis of prospective comparison of MRCP and EUS for the detection of choledocholithiasis yielded statistically similar diagnostic values for both techniques.