Biomedical subjects

G H Elta

Publications and source records attributed to G H Elta.

57 records · Page 4Linked to original sources

PubMedDate not supplied

Meperidine need not be proscribed during sphincter of Oddi manometry.

Meperidine is routinely proscribed during sphincter of Oddi manometry because narcotics have been associated with spasm of the sphincter of Oddi. We have performed a prospective study of the effect of meperidine on sphincter of Oddi manometry in 18 patients undergoing manometry for suspected sphincter dysfunction. After diagnostic manometry using only intravenous diazepam sedation, the endoscope remained in the duodenum while 1 mg/kg intravenous meperidine was given. Five minutes later sphincter manometry was repeated. There was no difference in the baseline sphincter pressure before and after meperidine in all patients. The frequency of phasic contractions increased after meperidine (p = 0.001). Baseline sphincter pressure is generally the only manometric criteria used to diagnose sphincter dysfunction and this did not change after meperidine. We conclude that meperidine may be used for additional analgesia during sphincter manometry. This may improve patient tolerance and the success rate of this procedure.

Adult↗

PubMedDate not supplied

Utility of a linear array ultrasound endoscope in the evaluation of suspected pancreatic disease.

Endoscopic ultrasonography (EUS) is currently being used to evaluate and stage pancreaticobiliary malignancies and neuroendocrine tumors, and to perform aspiration for cytologic diagnosis. There are currently two different commercially available EUS systems for clinical use. One system uses a mechanical radial sector scanner oriented in a plane perpendicular to the long axis of the endoscope, and the other uses an electronic convex scanner that is oriented in the long axis of the endoscope. The vast majority of the current literature reports experience using the radial scanning device in the evaluation of pancreaticobiliary abnormalities. We prospectively evaluated the linear probe as the sole instrument for EUS in 26 patients with suspected pancreatic disease. The results of the endoscopic ultrasound examination were compared with the results of surgery or long-term clinical follow-up. The sensitivity and specificity of linear array EUS for benign pancreatic disease were 93.8% and 88.2%, respectively. The sensitivity and specificity for malignant disease of the pancreas were 80.0% and 88.9%, respectively. The linear array echoendoscope, employed as the only instrument for evaluation of the pancreas, is accurate in the evaluation of pancreatic disease. The addition of EUS-guided pancreatic biopsy would be anticipated to improve the sensitivity of the linear array instrument for detecting malignancy.

Endoscopes↗

PubMedDate not supplied

Helicobacter pylori in patients with nonulcer dyspepsia.

The relationship between endoscopically diagnosed gastroduodenitis, histologically confirmed gastritis, and symptoms of dyspepsia remains unclear. Marked histologically confirmed inflammation of gastric mucosa often occurs in a stomach that appears normal by endoscopy. Both histologically confirmed and endoscopically diagnosed gastritis are commonly blamed as causes of nonulcer dyspepsia (NUD), although neither disease has been convincingly shown to cause NUD. Helicobacter pylori infection of gastric mucosa is a common cause of histologically confirmed inflammation. It is unclear whether this infection with H. pylori and the resultant gastric mucosal inflammation cause symptoms since inflamed mucosae are also common in asymptomatic controls. The reported increased prevalence of H. pylori in patients with NUD compared with controls suggests a possible causative role in at least a subset of patients with NUD. In addition, three controlled studies of treatment with bismuth demonstrated a significant trend toward improvement of symptoms after clearance of H. pylori. However, two studies of therapy with bismuth failed to demonstrate improvement of symptoms. Further study of patients with NUD is needed to clarify this possible association.

Dyspepsia↗