http://hdl.handle.net/10147/204612 Thu, 23 May 2013 15:09:39 GMT 2013-05-23T15:09:39Z http://hdl.handle.net/10147/248972 Title: Rigid or flexible sigmoidoscopy in colorectal clinics? Appraisal through a systematic review and meta-analysis. Authors: Ahmad, Nasir Zaheer; Ahmed, Aftab Abstract: Rigid sigmoidoscopy is sometimes performed at first presentation in colorectal clinics. We assessed the feasibility of flexible sigmoidoscopy in similar situations by comparing it with rigid sigmoidoscopy as a first investigative tool. Fri, 01 Jun 2012 00:00:00 GMT http://hdl.handle.net/10147/248972 2012-06-01T00:00:00Z http://hdl.handle.net/10147/246274 Title: The Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease. Authors: Kent, Brian D; Eltayeb, Elhadi E; Woodman, Alastair; Mutwali, Arif; Nguyen, Hoang T; Stack, Austin G Abstract: Background: Chronic obstructive pulmonary disease (COPD) and tobacco use are leading causes of morbidity and mortality. The prevalence and clinical impact of COPD on mortality and kidney transplantation among patients who begin dialysis therapy is unclear. Methods: We explored the clinical impact of COPD and continued tobacco use on overall mortality and kidney transplantation in a national cohort study of US dialysis patients. National data on all dialysis patients (n = 769,984), incident between May 1995 and December 2004 and followed until October 31, 2006, were analyzed from the United States Renal Data System. Prevalence and period trends were determined while multivariable Cox regression evaluated relative hazard ratios (RR) for death and kidney transplantation. Results: The prevalence of COPD was 7.5% overall and increased from 6.7 to 8.1% from 1995-2004. COPD correlated significantly with older age, cardiovascular conditions, cancer, malnutrition, poor functional status, and tobacco use. Adjusted mortality risks were significantly higher for patients with COPD (RR = 1.20, 95% CI 1.18-1.21), especially among current smokers (RR = 1.28, 95% CI 1.25-1.32), and varied inversely with advancing age. In contrast, the adjusted risks of kidney transplantation were significantly lower for patients with COPD (RR = 0.47, 95% CI 0.41-0.54, for smokers and RR = 0.54, 95% CI 0.50-0.58, for non-smokers) than without COPD [RR = 0.72, 95% CI 0.70-0.75, for smokers and RR = 1.00 for non-smokers (referent category)]. Conclusions: Patients with COPD who begin dialysis therapy in the US experience higher mortality and lower rates of kidney transplantation, outcomes that are far worse among current smokers. Fri, 07 Sep 2012 00:00:00 GMT http://hdl.handle.net/10147/246274 2012-09-07T00:00:00Z http://hdl.handle.net/10147/245032 Title: Management of chemotherapy-induced nausea and vomiting. Authors: Zubairi, Ishtiaq H Abstract: Chemotherapy-induced nausea and vomiting are symptoms that cause major concern to oncology patients. This article explores the types of nausea and vomiting in the context of chemotherapy, and discusses their pathogenesis and management. Tue, 01 Aug 2006 00:00:00 GMT http://hdl.handle.net/10147/245032 2006-08-01T00:00:00Z http://hdl.handle.net/10147/205730 Title: Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery. Authors: Sugrue, Michael; Buhkari, Yasir Abstract: BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH. Tue, 31 Jan 2012 16:31:34 GMT http://hdl.handle.net/10147/205730 2012-01-31T16:31:34Z