Endoscopic retrograde cholangiopancreatography complications in the era of cholangioscopy: is there an increased risk?

Background: Single-operator cholangioscopy allows direct visualization of the biliary tree and is being used in the diagnosis and treatment of various biliary conditions. To date, there are few data examining complications of single-operator cholangioscopy.

Methods: We evaluated all endoscopic retrograde cholangiopancreatography procedures over a two-year period and compared its complication rate to single-operator cholangioscopy in a tertiary care centre with extensive experience in single-operator cholangioscopy.

When to reconsider the diagnosis of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a highly prevalent disorder characterized by nonspecific symptoms that can mimic other common medical conditions. A careful history and physical examination may reveal clues that suggest a coexisting or alternative diagnosis, such as small intestinal bacterial overgrowth or celiac disease (CD). Testing for bacterial overgrowth has limitations, but emerging data suggest that antibiotics may be of some benefit in patients with IBS with diarrhea and bloating.

Updates on treatment of irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated to affect 10%-15% of the Western population, and has a large impact on quality of life and (in)direct healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and post-infectious inflammation.

Statistical tests of demographic heterogeneity theories.

In this paper we develop predictions from models of life-long demographic heterogeneity. These predictions are then compared to observations of mortality in large laboratory populations of Drosophila melanogaster. We find that the demographic heterogeneity models either require levels of variation that far exceed what would be considered biologically plausible, or they predict a much larger number of very old individuals than we actually observe.