Gastric lavage in patients with gastrointestinal hemorrhage: yea or nay?

Article Abstract:

Gastrointestinal tubes inserted through the nose or mouth are commonly used to examine the contents of the stomach in patients with suspected gastrointestinal bleeding. Another study in this issue examined the usefulness of nasogastric aspiration in diagnosing cases of gastrointestinal bleeding. Nasogastric aspiration is the sampling of stomach contents by suctioning fluids though a tube inserted into the stomach by way of the nose. Various aspects concerning the criteria used by physicians in deciding whether to use a diagnostic approach such as nasogastric aspiration, and the design of this particular study, were assessed. The clinical decision-making processes of physicians are often based on personal and/or peer experiences and research interests, and on individual case reports. However, most diagnostic and therapeutic decisions rely on the randomized control trial (RCT). Differences in results of RCTs may result from differences in patient selection, the choice of too small a population for study, or poor design of the study. The criteria to assess the accuracy of RCTs include definition of strict study criteria, blinding of all personnel involved in the study to avoid any form of bias, and thorough consideration of all statistical aspects. The study examining the effectiveness of nasogastric aspiration in diagnosing gastrointestinal bleeding in this issue has various problems in its study design. These problems may interfere with the accurate interpretation of results. However, this study contributes useful information for making clinical decisions, and also provides the basis for future carefully designed studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Research, Clinical trials, editorial, Gastric lavage

---

Vitamin E deficiency and psychomotor dysfunction in adults with primary biliary cirrhosis

Article Abstract:

Scientists have discovered that animals with chronic vitamin E deficiency develop severe neurologic abnormalities. Similar problems have resulted in children with medical conditions that inhibit fat absorption and thereby reduce absorption of vitamin E, since it is a fat-soluble vitamin. In this study, adults with primary biliary cirrhosis were tested to determine the incidence of vitamin E deficiency and the association between vitamin E deficiency and psychomotor function. Primary biliary cirrhosis is a chronic liver disease that involves inflammation of the bile ducts and abnormal retention of bile; bile needs to flow into the small intestine in order to digest fats. Thus patients with this condition would be expected to have impaired absorption of fats, and consequently, vitamin E. Indeed, of the 42 women with primary biliary cirrhosis, 44 percent were diagnosed with vitamin E deficiency. Subjects with and without vitamin E deficiency were compared on their performance on eight psychomotor tests. The tests involved such functions as spacial abilities, visual scanning, attention span, and hand-eye coordination. On six of the eight tests, the vitamin-E deficient subjects did significantly worse than a group of 15 healthy controls, and the patients without vitamin E deficiency did not differ from the controls on their test performance. The patients with low blood levels of vitamin E also had neurological abnormalities. In conclusion, vitamin E deficiency may contribute to the neurological and psychomotor dysfunction seen in patients with primary biliary cirrhosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Complications and side effects, Cholestasis, Vitamin E deficiency, Biliary tract, Psychomotor disorders, Biliary cirrhosis

---

Gastrointestinal tract hemorrhage: the value of a nasogastric aspirate

Article Abstract:

Nasogastric aspiration is a procedure in which a tube is inserted, by way of the nose, into stomach, and fluid from the stomach is sampled by aspiration or suction. The presence of a bloody aspirate is thought to indicate gastrointestinal tract bleeding, whereas a nonbloody yellow-green aspirate suggests the absence of bleeding near the ligament of Treitz, which is located at the beginning of the small intestine. The detection of active bleeding as compared to recently stopped or inactive bleeding is important in planning treatment of gastrointestinal bleeding. The effectiveness of nasogastric aspiration in predicting gastrointestinal bleeding was assessed in 73 episodes of bleeding in 62 patients. Gastrointestinal bleeding was confirmed by endoscopy, a procedure in which a tube-like optical instrument is used to directly examine body organs or cavities. The results show that endoscopic findings were related to the appearance of the nasogastric aspirate. However, nasogastric aspiration had a low sensitivity of 79 percent, and a low specificity of 55 percent in predicting gastrointestinal bleeding. These findings do not support the use of nasogastric aspiration to predict gastrointestinal bleeding, or to locate the precise source of the bleeding. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aspiration and aspirators, Aspiration (Physiology)

Similar abstracts:

• Abstracts: Clinical prognostic factors in patients with posterior uveal malignant melanoma
• Abstracts: Improving survival and limb salvage in patients with aortic graft infection. Surgical treatment of distal ulnar artery aneurysm
• Abstracts: Psychological profiles of patients with upper gastrointestinal symptomatology induced by non-steroidal anti-inflammatory drugs
• Abstracts: A comparison of nutritional management with stress management in the treatment of bulimia nervosa. To weigh or not to weigh? Frequency of weighing and rate of weight gain in patients with anorexia nervosa
• Abstracts: The HIV-testing policies of US hospitals. Management of patients with HIV/AIDS: who should care? The United States needs a health system like other countries

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.