Objective. Gastric acid inhibition is beneficial in the management of peptic ulcer bleeding (PUB). The aim of this double-blind study was to test whether somatostatin (SST) increases intragastric pH in PUB as compared...Objective. Gastric acid inhibition is beneficial in the management of peptic ulcer bleeding (PUB). The aim of this double-blind study was to test whether somatostatin (SST) increases intragastric pH in PUB as compared with pantoprazole (PAN) and placebo (PLA). Material and methods. Eligible patients were randomized to receive SST (500 μg/h +250 μg bolus), or PAN (8 mg/h+80 mg bolus) or PLA (normal saline) i.v., for 24 h. All patients underwent gastric pH monitoring during the infusion of the trial drugs. Results. The three groups (SST, n = 14; PAN, n = 14; PLA, n = 15) were comparable for age, gender, aetiology of PUB and laboratory data at admission. Mean (±SE) baseline pH levels in the fundus increased during the administration of the trial drugs (SST: 1.94±0.18 to 6.13±0.37, p < 0.000 1; PAN: 1.93±0.16 to 5.65±0.37, p < 0.000 1;PLA: 1.86±0.12 to 2.10±0.15, p = 0.091 7). During the first 12 h of infusion, the mean (±SE) percentage time spent above pH 4.0 and 5.4 was higher with SST versus PAN (84.4%±4.8 versus 55.1%±8.3, p = 0.004 9 and 74.2%±6.5 versus 47.1%±8.3, p = 0.016 3, respectively) and there was a trend favouring the SST group regarding the time spent above pH 6.0 and 6.8 (65.7%±6.4 versus 43.3%±8.2, p = 0.066 9 and 49.2%±7.7 versus 28.4±6.6, p = 0.073 8, respectively). Conclusions. In PUB, both SST and PAN inhibit gastric acid secretion as compared with placebo. However, during the first 12 h of the infusion, SST was more effective than PAN in maintaining high intragastric pH. These results may provide a rationale for the administration of SST in PUB.展开更多
Background: The aim of this study was to determine the value of small-bowel preparation for patients undergoing capsule endoscopy. Methods: The study design was prospective, randomized, and controlled. Eighty patients...Background: The aim of this study was to determine the value of small-bowel preparation for patients undergoing capsule endoscopy. Methods: The study design was prospective, randomized, and controlled. Eighty patients referred for capsule endoscopy were randomized into two equal groups. Patients in Group A (mean age 54.40 [15.65] years) ingested 2 L of a polyethylene glycol/electrolyte solution 16 hours before the test, whereas patients in Group B (mean age 59.85 [14.58] years) prepared for the procedure by taking only clear liquids during the prior day. The primary outcome evaluated was the effect of bowel preparation on the quality of capsule images, as assessed with an objective scoring system in which cleansing was graded as “adequate”or “inadequate”by blinded examiners. A secondary outcome was the effect of bowel preparation on diagnostic yield. For this purpose, the results of capsule endoscopy were classified as positive findings, findings of uncertain significance, and no findings. Results: Cleansing of the small intestine was considered “adequate" in 36 patients in Group A (90%) vs. 24 patients of Group B (60%) (p = 0.004). A diagnosis was established in 26 patients in Group A (65%) compared with 12 patients in Group B (30%) (p = 0.003). Conclusions: Bowel preparation before capsule endoscopy improves visualization of the small intestine, which may lead to an improvement in diagnostic yield.展开更多
文摘Objective. Gastric acid inhibition is beneficial in the management of peptic ulcer bleeding (PUB). The aim of this double-blind study was to test whether somatostatin (SST) increases intragastric pH in PUB as compared with pantoprazole (PAN) and placebo (PLA). Material and methods. Eligible patients were randomized to receive SST (500 μg/h +250 μg bolus), or PAN (8 mg/h+80 mg bolus) or PLA (normal saline) i.v., for 24 h. All patients underwent gastric pH monitoring during the infusion of the trial drugs. Results. The three groups (SST, n = 14; PAN, n = 14; PLA, n = 15) were comparable for age, gender, aetiology of PUB and laboratory data at admission. Mean (±SE) baseline pH levels in the fundus increased during the administration of the trial drugs (SST: 1.94±0.18 to 6.13±0.37, p < 0.000 1; PAN: 1.93±0.16 to 5.65±0.37, p < 0.000 1;PLA: 1.86±0.12 to 2.10±0.15, p = 0.091 7). During the first 12 h of infusion, the mean (±SE) percentage time spent above pH 4.0 and 5.4 was higher with SST versus PAN (84.4%±4.8 versus 55.1%±8.3, p = 0.004 9 and 74.2%±6.5 versus 47.1%±8.3, p = 0.016 3, respectively) and there was a trend favouring the SST group regarding the time spent above pH 6.0 and 6.8 (65.7%±6.4 versus 43.3%±8.2, p = 0.066 9 and 49.2%±7.7 versus 28.4±6.6, p = 0.073 8, respectively). Conclusions. In PUB, both SST and PAN inhibit gastric acid secretion as compared with placebo. However, during the first 12 h of the infusion, SST was more effective than PAN in maintaining high intragastric pH. These results may provide a rationale for the administration of SST in PUB.
文摘Background: The aim of this study was to determine the value of small-bowel preparation for patients undergoing capsule endoscopy. Methods: The study design was prospective, randomized, and controlled. Eighty patients referred for capsule endoscopy were randomized into two equal groups. Patients in Group A (mean age 54.40 [15.65] years) ingested 2 L of a polyethylene glycol/electrolyte solution 16 hours before the test, whereas patients in Group B (mean age 59.85 [14.58] years) prepared for the procedure by taking only clear liquids during the prior day. The primary outcome evaluated was the effect of bowel preparation on the quality of capsule images, as assessed with an objective scoring system in which cleansing was graded as “adequate”or “inadequate”by blinded examiners. A secondary outcome was the effect of bowel preparation on diagnostic yield. For this purpose, the results of capsule endoscopy were classified as positive findings, findings of uncertain significance, and no findings. Results: Cleansing of the small intestine was considered “adequate" in 36 patients in Group A (90%) vs. 24 patients of Group B (60%) (p = 0.004). A diagnosis was established in 26 patients in Group A (65%) compared with 12 patients in Group B (30%) (p = 0.003). Conclusions: Bowel preparation before capsule endoscopy improves visualization of the small intestine, which may lead to an improvement in diagnostic yield.
