Prevalence of Hidden Gastroparesis in the Community: The Gastroparesis "Iceberg"

BACKGROUND/AIMS: The prevalence of diagnosed gastroparesis is 24.2/100,000 inhabitants, but a large group of people with gastroparesis-like symptoms have never had a gastric emptying (GE) test. Some of them may have undiagnosed gastroparesis. Our aim was to estimate the prevalence of hidden gastroparesis in the community. METHODS: The study was conducted in 2 parts: (1) Patients referred for a scintigraphic GE test completed a validated questionnaire (Bowel Disease Questionnaire). Multiple linear regression models to predict 2 hours and 4 hours GE rates were developed. (2) A revised Bowel Disease Questionnaire was mailed to a random sample of 4,194 Olmsted County residents. GE rates were estimated with the models for each subject and delayed GE was considered when they were lower than normal values. Hidden gastroparesis was defined in community subjects with predicted delayed GE that had not been diagnosed with gastroparesis prior to the survey. RESULTS: The regression models for GE rates were constructed using data from 450 patients. In addition to age and gender, the symptoms found significant were nausea/vomiting, early satiety, upper abdominal pain, bloating, loss of appetite and weight loss more than 7 pounds. 2,298 (55%) community subjects returned a questionnaire. Five subjects were excluded due to a prior diagnosis of gastroparesis. When models were applied to the community survey data, 42 (1.8%) subjects were estimated to have delayed GE. CONCLUSIONS: Delayed GE was estimated to occur in 1.8% of community subjects. Since the prevalence of diagnosed gastroparesis is low (0.02%), many subjects with gastroparesis may remain undiagnosed.

Psychometric properties of a persian version of the specialty indecision scale: a Preliminary study

Diagnosis and management of specialty choice indecision is an important part of career guidance and support for medical students. Determining causes of indecision and resolving them helps students to make an optimum decision. The aim of this study was to determine the psychometric properties of a Persian version of the specialty indecision scale as an on-line questionnaire for medical student and graduates of Isfahan University of medical sciences, and also to determine the attitude of the participants towards this questionnaire. In this cross-sectional study, using Richard's specialty indecision questionnaire, the Iranian version of the questionnaire for clinical specialty indecision was developed. Face validity and cultural validity were confirmed by educational experts, and translation, back translation method, respectively. Then, the participants completed the online version of the questionnaire. Afterward, the questionnaire's items were factor analyzed. At the end, Subjects were asked about the questionnaire [clarity of the questionnaire, attractiveness of the website, user friendliness of the questionnaire, number of personal questions]. Fifty eight subjects participated in this study. The reliability of the questionnaire was acceptable [0.84]. Two questions were omitted and five were revised. Items were grouped in 4 factors [general indecisiveness, postponing, barriers, and lack of determination] one of which [barriers] was similar to the American version. The subjects were also satisfied with online questionnaire and 100% of them thought completion of the tool was useful. This study showed that conducting a web based specialty indecision questionnaire is possible. It had differences with the American version both in number of factors and the items placement. These differences are justifiable in terms of the differences in cultural backgrounds and residency admission processes in the two countries. Also, lack of attention to translating the questions and inadequacy of sample size could be other reasons for these differences. With regard to the fact that there are no career counselors in Iranian universities, operating a web based career guidance system, along with introducing a counselor, may help medical students in specialty choice decision making

The Epidemiology of Irritable Bowel Syndrome / 대한소화관운동학회지

NO abstract available.

Mordeduras de serpiente

Se realizó un estudio descriptivo analizando cincuenta historias clínicas de pacientes con diagnóstico de mordedura de serpientes, hospitalizados en 1996, tomando en cuenta: edad, sexo, ocupación, sintomatología, tratamiento y complicaciones. Los resultados demostraron que hay mayor frecuencia de varones (76 por ciento) sobre mujeres (24 por ciento) con una edad promedio de 30.5 años, la sintomatología local fue de dolor intenso, edema e inflamación aguda, mientras que los síntomas generales fueron taquicardia, hemorragia gingival, hemorragia cutánea. El sitio más frecuente de la mordedura fueron las extremidades superiores (60 por ciento); siendo los agricultores los más afectados (40 por ciento), se realizó previamente pruebas de coagulación al 100 por ciento de los casos...