1) Duodenal polyps are found in 4.6% of patients referred to upper endoscopy and should therefore be looked for. 2) Multiple, small polyps in the duodenal bulb are always benign and need neither biopsy nor treatment (in patients with familial polyposis biopsy is recommended). 3) In the descending duodenum polyps are rare, but a substantial number of them are adenomas. Biopsy is therefore mandatory in this localization.
During a ten-year period 193 patients with an appendiceal mass--and subsequently proved postinflammatory changes of the appendix--were treated conservatively. The course was uneventful in 88%. Twelve per cent underwent delayed surgical intervention caused by complications with one death. Elective appendectomy was performed after three months with a complication rate of 3.4%. In comparison with series with early operation the conservative management seems to carry a lower morbidity. The value of elective appendectomy is discussed.
One hundred and sixty two patients with endoscopically proved reflux oesophagitis stratified for severity, 66 with grade 1 disease (erythema and friability) and 96 with grade 2 or 3 disease (including erosions or ulcerations), were aliocated at random to double blind treatment with omeprazole 40 mg in the morning or ranitidine 150 mg twice daily for up to 12 weeks. A patient could be evaluated sooner if symptomatic relief and endoscopicaily normal mucosa (grade 0) were noted after four to eight weeks' treatment. Patients treated with omeprazole responded significantly more rapidly than those treated with ranitidine (p<00001), cumulative healing rates at four, eight, and 12 weeks being 90%, 100%, and 100% respectively for those with grade 1 disease and 70%, 85%, and 91% respectively for those with grade 2 or 3 disease in the omeprazole group. Corresponding rates in the ranitidine group were 55%, 79%, and 88% (grade 1) and 26%, 44%, and 54% (grade 2 or 3). Relief of the major symptoms of heartburn, regurgitation, and dysphagia and improvements in the histological appearance of the mucosa occurred earlier and were
Rectosigmoid pressure recordings by means of open-ended perfused catheters were performed on 21 patients with the irritable bowel syndrome (IBS). Motility indexes were calculated in resting conditions, after sham feeding, after a meal, and after 0.5 mg neostigmine intravenously. Each step of stimulation caused a significantly increased motility index compared with the previous step (p less than 0.01). The increase in rectosigmoid pressure activity after sham feeding indicates the existence of a cephalic phase in the postprandial motor response of the colon in IBS.
One hundred and sixty two patients with endoscopically proved reflux oesophagitis stratified for severity, 66 with grade 1 disease (erythema and friability) and 96 with grade 2 or 3 disease (including erosions or ulcerations), were aliocated at random to double blind treatment with omeprazole 40 mg in the morning or ranitidine 150 mg twice daily for up to 12 weeks. A patient could be evaluated sooner if symptomatic relief and endoscopicaily normal mucosa (grade 0) were noted after four to eight weeks' treatment. Patients treated with omeprazole responded significantly more rapidly than those treated with ranitidine (p<00001), cumulative healing rates at four, eight, and 12 weeks being 90%, 100%, and 100% respectively for those with grade 1 disease and 70%, 85%, and 91% respectively for those with grade 2 or 3 disease in the omeprazole group. Corresponding rates in the ranitidine group were 55%, 79%, and 88% (grade 1) and 26%, 44%, and 54% (grade 2 or 3). Relief of the major symptoms of heartburn, regurgitation, and dysphagia and improvements in the histological appearance of the mucosa occurred earlier and were
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.