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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 41 (1996), S. 372-376 
    ISSN: 1573-2568
    Keywords: gastroesophageal reflux ; achalasia ; scleroderma ; sleep
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Polysomnography and esophageal pH studies were conducted in 13 patients with an aperistaltic esophagus; seven of these had scleroderma and six were patients treated for achalasia. The percentage total time of pH 〈4.0 when recumbent exceeded 30% for both groups. There was a total of 51 reflux events for both groups. There were 22 reflux events recorded for both groups that were less than 5 min in length and 29 events greater than 5 min. In 26 of 32 (81%) instances, patients either began awake and went to sleep during a reflux event or did not awake during a reflux event. Only six of 32 (19%) reflux events caused sleep disruption. We conclude that even the severe reflux demonstrated in this subset of patients does not always disrupt sleep. Patients may have severe prolonged reflux and not arouse.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 32 (1987), S. 1239-1243 
    ISSN: 1573-2568
    Keywords: colonoscopy ; polypectomy ; bacteremia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective assessment was made of the frequency of positive blood cultures in patients undergoing colonoscopy with or without polypectomy. A total of 270 patients underwent 280 colonoscopies, of these, there were 105 patients that had 111 polypectomies. Blood cultures were taken prior to and within 15 min following each procedure. Six of 280 (2.1%) preprocedural blood cultures were positive. Seven of 169 (4%) blood cultures were positive within 15 min of insertion of the colonoscope in the colonoscopy only group. Eight of 223 (3.6%) blood cultures were positive within 10 min of the polypectomy. There was no clinical evidence of sepsis during the 24 hr following these procedures. In order to determine appropriate postprocedural sampling interyals, we induced aStaphylococcus epidermidis bacteremia with a mean of 1.16×106 colony forming units/ml on 10 occasions in seven dogs. Within 30 min of inoculation, we were able to detect only one colony forming unit/ml. The rate of positive blood cultures during colonoscopy alone and following polypectomy during colonoscopy is comparable to other gastrointestinal endoscopy procedures. The most optimal time to collect blood cultures in order to detect transient bacteremia is as soon after the procedure as is feasibly possible.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 43 (1998), S. 834-839 
    ISSN: 1573-2568
    Keywords: 24-HOUR pH TESTING ; AMBULATORY MONITORING ; ESOPHAGEAL TEST ; GASTROESOPHAGEAL REFLUX
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A prospective investigation of the impact ofingested liquids on 24-hr pH test scores was conducted.Eighty-two patients contributed 142 samples. The liquidsused were coffee/tea (N = 35), water (N = 32), fruit juice (N = 29), cola (N = 34), and beer (N =12). The pH of cola, juice, and beer are approximately3.0. The parameters studied included: total test time,total drink time, total minutes of pH 〈 4.0 during drink, minutes of pH 〈 4.0 10 min beforedrink, and minutes of pH 〈 4.0 10 min followingdrink. Analysis was performed using one-way ANOVA andrepeated measures. Age of patients, total test time, and total time pH 〈 4.0 were notsignificantly different (P 〉 0.05). The total time toconsume the drink was significantly greater (P 〈0.05) for beer than all other liquids. The total time(7.7 ± 6.0 min) pH 〈 4.0 for cola wassignificantly different (P 〈 0.023) than beer (3.3± 3.7 min), tea/coffee (1.4 ± 6.5 min),and water (1.1 ± 2.5 min). The percentage oftotal time pH 〈 4.0 was not significantly different (P 〉0.05) among any of the liquids. The percentage of timepH 〈 4.0 during the drink was the highest for cola(63 ± 47%) and juice (51 ± 57%); water,coffee/tea, and beer were not significantly different (P〉 0.05). Although the impact of cola and juice werethe greatest, none of these had an impact that exceeded0.5%. The lack of impact of beer appears to be due to the increased period of time it takes toconsume. We conclude that the impact of ingested fluidsis minimal and can probably be disregarded in mostpatient groups.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 17 (1992), S. 347-352 
    ISSN: 1432-0509
    Keywords: Bile ducts, MR studies, neoplasms, diseases ; Bile duct radiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors compared computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP), techniques commonly used to study the biliary tree, with pre- and post-Gd-DTPA breath-hold fast low angle shot (FLASH) and fat suppressed spin-echo in 28 consecutive patients with bile duct abnormalities detected on ERCP, including 11 patients with malignant disease and 17 patients with benign disease. ERCP, CT, and magnetic resonance (MR) images were prospectively interpreted in a blinded fashion and reviewed by consensus. ERCP characterized all cases of malignant disease by the presence of a narrowed bile duct lumen with irregular margins. CT and MRI detected all cases of malignant disease and characterized nine of 11 as malignant. In seven of these cases, CT and MRI showed thickening of extrahepatic bile duct walls 〉5 mm. MRI images showed intrahepatic-enhancing periportal tissue in four cases, which was not seen on CT images, and which was biopsyproven tumor extension. Benign disease was characterized on ERCP images by the demonstration of smooth tapered narrowings in 16 cases, whereas on CT and MR images it was characterized by mild to moderate dilatation of the intrahepatic bile ducts and wall thickness 〈 5 mm in 13 cases. Overall ERCP correctly characterized 27 cases as benign or malignant and CT and MRI both characterized 25. The results of this study show a trend that ERCP is superior to CT and MRI for characterizing bile duct disease.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Dysphagia 11 (1996), S. 248-251 
    ISSN: 1432-0460
    Keywords: Ambulatory esophageal pH testing ; Achalasia ; Scleroderma ; Gastroesophageal reflux ; Deglutition ; Deglutition disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The reproducibility of ambulatory 24-h esophageal pH monitoring was evaluated in 16 consecutive patients by comparing the difference in two consecutive 24-h periods. The study group included 8 patients with scleroderma esophagus and 8 treated achalasia patients. The amount of reflux was expressed as the percentage of time the pH was 〈4.0. Both groups demonstrated excellent intrapatient reproducibility overall: 96% in scleroderma patients and 95% in those patients with achalasia. The least concordance was found in the lengths of the longest reflux event—70% when supine in scleroderma patients and 59% when upright in patients with achalasia. There was no significant difference (p〉0.05) between day 1 and day 2 for either group of patients for any of the elements studied. These results indicate that intrapatient variability of gastroesophageal reflux in patients with scleroderma esophagus and treated patients with achalasia is very low and following therapeutic intervention, a high level of confidence can be placed in subsequent pH monitoring as an indicator of treatment effect.
    Type of Medium: Electronic Resource
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