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BACKGROUND There are few data on empiric, stepped therapy for heartburn relief or subsequent relapse in primary care. AIMS To compare heartburn relief produced by a proton pump inhibitor-start or an H(2)-receptor antagonist-start with step-up therapy, as needed, followed by a treatment-free period to assess relapse. METHODS Heartburn-dominant(More)
CONTEXT Recent reports suggest an increasing occurrence and severity of Clostridium difficile-associated disease. We assessed whether the use of gastric acid-suppressive agents is associated with an increased risk in the community. OBJECTIVE To determine whether the use of gastric acid-suppressive agents increases the risk of C difficile-associated(More)
Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. 1 Colonoscopy can prevent CRC by the detection and removal of precan-cerous lesions. In addition to CRC screening and surveillance , colonoscopy is used widely for the diagnostic evaluation of symptoms and other positive CRC screening tests. Regardless of(More)
BACKGROUND The management of patients with acute nonvariceal upper gastrointestinal bleeding has evolved substantially over the past 10 years amid a paucity of published consensus guidelines. PURPOSE To provide evidence-based management recommendations that address clinically relevant issues. REVIEW AND CONSENSUS PROCESSES: A multidisciplinary consensus(More)
OBJECTIVE To develop a model to predict the bleeding source and identify the cohort amongst patients with acute gastrointestinal bleeding (GIB) who require urgent intervention, including endoscopy. Patients with acute GIB, an unpredictable event, are most commonly evaluated and managed by non-gastroenterologists. Rapid and consistently reliable risk(More)
Laparoscopic cholecystectomy (LC) has gained wide acceptance for treatment of cholelithiasis in preference to open cholecystectomy, though it has not been formally compared with mini cholecystectomy (MC). We have compared these two techniques in a randomised trial. 70 patients with ultrasound-proven cholelithiasis were randomly allocated LC (38) or MC (32);(More)
Acute upper gastrointestinal bleeding is a common medical emergency worldwide, a major cause of which are bleeding peptic ulcers. Endoscopic treatment and acid suppression with proton-pump inhibitors are cornerstones in the management of the disease, and both treatments have been shown to reduce mortality. The role of emergency surgery continues to(More)
In a population-based case-control study of community acquired Clostridium difficile-associated disease (CDAD), we matched 1,233 cases to 12,330 controls. CDAD risk increased 3-fold with use of any antimicrobial agent and 6-fold with use of fluoroquinolones. Prior use of antimicrobial agents did not affect risk for CDAD after 6 months.
BACKGROUND Gastro-esophageal reflux disease (GERD) is a common disease. It impairs health related quality of life (HRQL). However, the impact on utility scores and work productivity in patients with moderate to severe GERD is not well known. METHODS We analyzed data from 217 patients with moderate to severe GERD (mean age 50, SD 13.7) across 17 Canadian(More)
We present a test-retest dataset of resting-state fMRI data obtained in 80 cognitively normal elderly volunteers enrolled in the "Pre-symptomatic Evaluation of Novel or Experimental Treatments for Alzheimer's Disease" (PREVENT-AD) Cohort. Subjects with a family history of Alzheimer's disease in first-degree relatives were recruited as part of an on-going(More)