The American journal of gastroenterology
-
Am. J. Gastroenterol. · Aug 2007
Randomized Controlled Trial Comparative StudyEffect of a proton pump inhibitor or an H2-receptor antagonist on prevention of bleeding from ulcer after endoscopic submucosal dissection of early gastric cancer: a prospective randomized controlled trial.
With conventional methods of endoscopic mucosal resection for early gastric cancer (EGC), proton pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs) have a similar effect on preventing bleeding from artificial ulcers. An objective of this study is to investigate whether a stronger acid suppressant (i.e., PPI) more effectively prevents bleeding after the recent advanced technique of endoscopic submucosal dissection (ESD) for EGC. ⋯ PPI therapy more effectively prevented delayed bleeding from the ulcer created after ESD than did H2RA treatment.
-
Am. J. Gastroenterol. · Oct 2006
Randomized Controlled Trial Comparative StudyPropofol alone titrated to deep sedation versus propofol in combination with opioids and/or benzodiazepines and titrated to moderate sedation for colonoscopy.
Propofol by nonanesthesiologists is controversial because the drug is commonly used to produce deep sedation or general anesthesia. Propofol in combination with opioids and/or benzodiazepines can be titrated to moderate sedation, which might be safer. ⋯ Propofol in combination with fentanyl and/or midazolam can be titrated to moderate levels of sedation without substantial loss of satisfaction and with shorter recovery times compared with propofol titrated to deep sedation throughout the procedure.
-
Am. J. Gastroenterol. · Sep 2006
Randomized Controlled TrialLevofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication.
The standard first-line therapies for Helicobacter pylori eradication are based on clarithromycin and amoxicillin or metronidazole. Recent studies suggested levofloxacin as an alternative option for both first-and second-line H. pylori eradication treatment. ⋯ A 7-day levofloxacin-based triple therapy can achieve higher H. pylori eradication rates than standard regimens. These data suggest levofloxacin-based regimens can be the most effective in first-line anti-H. pylori therapy, at least in the Italian population.
-
Am. J. Gastroenterol. · Sep 2006
Randomized Controlled TrialEfficacy of bispectral monitoring as an adjunct to nurse-administered propofol sedation for colonoscopy: a randomized controlled trial.
Bispectral (BIS) monitoring provides an objective, non-invasive measure of the level of consciousness in sedated patients. BIS has been shown to lag behind the level of sedation during induction and emergence of sedation with propofol. In this study, we sought to determine whether BIS is a useful adjunctive maneuver to registered nurse-administered propofol sedation (NAPS) as measured by reductions in recovery time and doses of propofol administered. ⋯ BIS did not lead to reductions in mean propofol dose or recovery time when used as an adjunct to NAPS for colonoscopy, or when used as the primary target for sedation. No clinically important role for BIS monitoring as an adjunct to NAPS has yet been established.
-
Am. J. Gastroenterol. · Jun 2006
Randomized Controlled TrialErythromycin infusion prior to endoscopy for acute upper gastrointestinal bleeding: a randomized, controlled, double-blind trial.
Presence of clots in the stomach makes emergency endoscopy difficult in patients with upper gastrointestinal bleeding. We investigated whether the association of erythromycin infusion to gastric lavage could improve stomach cleansing before endoscopy. ⋯ Intravenous erythromycin before endoscopy improves stomach cleansing and quality of endoscopic examination in patients with upper gastrointestinal bleeding, but the clinical benefit is limited.