ABSTRACT
BACKGROUND/AIMS: Sedation rates may vary among countries, depending on patients' and endoscopists' preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives' endoscopy units. RESULTS: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders' endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available 'in most of the endoscopy units' in 46% (13/28) of the countries. Though they were available in 91% of the national representatives' endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. CONCLUSIONS: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.
Subject(s)
Conscious Sedation/statistics & numerical data , Endoscopy, Gastrointestinal , Gastrointestinal Diseases/diagnosis , Female , Health Care Surveys , Humans , Hypnotics and Sedatives/administration & dosage , Male , Societies, Medical , Surveys and QuestionnairesABSTRACT
In an open study the clinical efficacy of famotidine 40 mg on a duodenal ulcer was compared to that of proglumide 1600 mg. The study included 106 patients with acute duodenal ulcer, divided into two groups: A-famotidine and B-proglumide. There were no significant differences between the groups in baseline characteristics. Due to different reasons nine patients were excluded from analysis. Duodenal ulcer diagnosis and healing were determined exclusively by endoscopy. Ulcer healing was observed after four weeks in 40/49 (81.6%) patients in group A and 35/48 (72.9%) patients in group B and in 46/49 (94%) and 40/48 (83.3) after eight weeks, respectively. There were no statistically significant differences between the healing rates for both groups (p > 0.05). The reduction of ulcer related symptoms and antacid consumption was equal in both groups. No adverse effects were reported in the group A, but there were three patients with transient skin rush in the group B. Reported adverse effects were minor and did not merit exclusion from the study. It was concluded that the efficacy of famotidine 40 mg vs. proglumide 1600 mg was similar, although famotidine had proportionally better effect than proglumide. These findings supported the hypothesis that famotidine suppressed acid secretion stronger than proglumide.
Subject(s)
Anti-Ulcer Agents/therapeutic use , Duodenal Ulcer/drug therapy , Famotidine/therapeutic use , Proglumide/therapeutic use , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
In 13 patients with isolated mitral stenosis in sinus rhythm the pulmonary venous flow was evaluated by transoesophageal pulsed Doppler echocardiography. The patients were divided into two groups according to their mitral valve area (MVA); Group I (MVA < 1.5 cm2, n = 7 patients); and Group II (MVA > 1.5 cm2, n = 6). The patients in group I with haemodynamically significant mitral stenosis had lower velocities of systolic (S), diastolic (D) and atrial retrograde (A) waves of pulmonary venous flow (PVF) compared to milder stenosis (P < 0.05). The peak velocity of pulmonary retrograde venous flow at atrial contraction (A) primarily depends on the relative amplitude of the atrial transmitral wave (RA), which is measured from the onset of atrial systole to its peak velocity. We found a highly positive correlation between RA of mitral valve flow (MVF) and A wave of PVF (r = 0.87, P < 0.0001). There was also a highly negative correlation (r = 0.80, P < 0.001) between A of PVF and ratio of early (PE) to late (PA) velocities of MVF. Therefore, the retrograde A wave of PVF is related to the pressure generated in the left atrium during atrial systole. Use of pulmonary vein velocities in conjunction with mitral flow velocities can increase our understanding of the haemodynamics of mitral stenosis and provide a new insight into left atrial performance.
Subject(s)
Atrial Function , Mitral Valve Stenosis/physiopathology , Pulmonary Veins/physiopathology , Sinoatrial Node/physiopathology , Systole , Adult , Atrial Function, Left , Blood Flow Velocity , Echocardiography, Doppler , Echocardiography, Transesophageal , Female , Humans , Male , Middle Aged , Mitral Valve/physiopathology , Mitral Valve Stenosis/diagnostic imagingSubject(s)
Kidney Failure, Chronic/urine , Oxalates/urine , Adolescent , Child , Child, Preschool , Female , Humans , Kidney Failure, Chronic/etiology , MaleSubject(s)
Kidney Failure, Chronic/blood , Lipids/blood , Adolescent , Child , Child, Preschool , Cholesterol/blood , Female , Humans , Kidney Failure, Chronic/therapy , Male , Renal Dialysis , Triglycerides/bloodSubject(s)
Renin/blood , Vesico-Ureteral Reflux/enzymology , Adolescent , Child , Child, Preschool , Humans , Vesico-Ureteral Reflux/diagnosisSubject(s)
Nephritis, Hereditary/diagnosis , Adolescent , Child , Child, Preschool , Female , Humans , Kidney/pathology , Male , Nephritis, Hereditary/pathology , SyndromeSubject(s)
Polyarteritis Nodosa/diagnosis , Adult , Age Factors , Child, Preschool , Female , Humans , Male , Polyarteritis Nodosa/pathologyABSTRACT
A boy aged 9 3/4 years with interstitial nephritis, retinal pigmentary dystrophy, cerebellar ataxia, and skeletal abnormalities is described. The association may be due to a new genetic disorder, since 2 similar cases have been reported.
