Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Jan 2015
Randomized Controlled Trial Comparative StudySedation during endoscopic retrograde cholangiopancreatography: a randomized controlled study of patient-controlled propofol sedation and that given by a nurse anesthetist.
Different regimens are used for sedation during endoscopic retrograde cholangiopancreatography (ERCP). Our objectives were to compare safety, ease of treatment, recovery, and patients' experiences using patient-controlled sedation (PCS) with propofol, nurse anesthetist-controlled sedation (ACS), or the department's standard of care, midazolam given by the procedure team (control group). ⋯ PCS with propofol is superior to midazolam and comparable to ACS. PCS resulted in a rapid recovery, fewer respiratory events, and was almost as effective as ACS in ensuring a successful examination.
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Scand. J. Gastroenterol. · Jan 2015
Early readmission in patients hospitalized for ulcerative colitis: incidence and risk factors.
Early readmission rates are becoming an integral measure of the quality of care for hospitalized patients with chronic diseases. The incidence and predictors of early readmission in patients with inflammatory bowel disease (IBD) are uncertain. Risk factors for readmission over the first few weeks may differ from those that influence re-hospitalization at later time points. We examined the incidence and predictors of both 30-day and 90-day readmissions among ulcerative colitis (UC) patients. ⋯ Early readmission is common in IBD. Independent risk factors for early readmission included extensive colitis, admission albumin, and being admitted to a housestaff service.
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Scand. J. Gastroenterol. · Jan 2015
Treatment of Clostridium difficile infection in a French university hospital.
The management of Clostridium difficile infection (CDI) has become very daunting over the past decade because of increased incidence and severity both in hospital and the community. Guidelines recommend metronidazole, vancomycin, or fidaxomicin, depending on clinical presentation. ⋯ This study identified significant gaps in our knowledge of CDI treatment. Increasing disease severity highlights the need to investigate antibiotic treatment in severely ill CDI patients, as data on this group are currently lacking.
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Scand. J. Gastroenterol. · Dec 2014
No antibiotics in acute uncomplicated diverticulitis: does it work?
The first randomized multicenter study evaluating the need for antibiotic treatment in patients with acute uncomplicated diverticulitis (AUD) could not demonstrate any benefit gained from antibiotic use. The aim of this study was to review the application of the no antibiotic policy and its consequences in regard to complications and recurrence. ⋯ The no-antibiotic policy for AUD is safe and applicable in clinical practice. The previous results of a low complication and recurrence rate in AUD are confirmed. There is no need for antibiotic treatment for AUD. What does this paper add to the literature? Despite published papers with excellent results, there are still doubts about patient safety against the policy to not use antibiotics in acute uncomplicated diverticulitis. This is the first paper, in actual clinical practice, to confirm that the no antibiotic policy for acute uncomplicated diverticulitis is applicable and safe.
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Scand. J. Gastroenterol. · Dec 2014
Comparative Study Clinical TrialFecal calprotectin is an effective diagnostic tool that differentiates inflammatory from functional intestinal disorders.
The clinical pictures of functional gastrointestinal disorders and inflammatory diseases can be quite similar leading to inappropriate and expensive investigations. Objective. To investigate fecal calprotectin (FC) diagnostic performance in different gastrointestinal conditions. ⋯ FC appears to be a reliable noninvasive biomarker of intestinal inflammation useful to improve the appropriateness of colonoscopy requests.