What to do when patients and physicians disagree? Qualitative research among physicians with different working experiences.

Purpose: Impasses between patients, relatives and physicians occur frequently. With the growing attention for shared decision making, it is valuable to know how impasses arise. To understand the challenges experienced by physicians when their opinion on medical decisions differ from those of patients or relatives.

Percutaneous endoscopic gastrostomy in older patients with and without dementia: Survival and ethical considerations.

Background And Aim: Notwithstanding multiple recommendations in guidelines, percutaneous endoscopic gastrostomy (PEG)-tube placement is still performed in patients with dementia. In this study, we aim to investigate survival in patients with and without dementia after PEG-tube placement.

Methods: We conducted a retrospective multicenter study in four different hospitals in the Netherlands.

Management of acute nonvariceal upper gastrointestinal bleeding: current policies and future perspectives.

Acute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6%-13%. The vast majority of these bleeds are due to peptic ulcers. Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease.

Update on the endoscopic management of peptic ulcer bleeding.

Upper gastrointestinal bleeding is the most common gastrointestinal emergency, with peptic ulcer as the most common cause. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of presentation.