The discriminative value of patient characteristics and dyspeptic symptoms for upper gastrointestinal endoscopic findings: a study on the clinical presentation of 1,147 patients.

The discriminative value of patient characteristics and dyspeptic symptoms for upper gastrointestinal endoscopic findings was prospectively assessed in 1,147 patients attending for their first diagnostic endoscopy and who answered paper (n = 431) or computerized (n = 716) questionnaires. The questionnaires provided detailed information concerning present dyspeptic symptoms, with special attention to provoking and/or relieving factors, and smoking and/or drinking habits. In logistic regression models each of a number of 'specific endoscopic diagnoses' was contrasted with normal endoscopy (n = 390), and 'relevant endoscopic disease' (oesophagitis, peptic ulcers, cancers; n = 269) was contrasted with 'irrelevant' and normal endoscopic findings (n = 878).

Appropriateness of indications for diagnostic upper gastrointestinal endoscopy: association with relevant endoscopic disease.

Background: Since the institution of open access endoscopy units there has been a considerable increase of referrals for UGI examinations. Therefore, guidelines for the appropriate use of UGI endoscopy are needed.

Methods: The outcome of first diagnostic UGI endoscopy was prospectively assessed for several referral indications in a consecutive series of 2900 patients.

Progression of a benign epithelial ampullary tumor to adenocarcinoma.

Benign tumors of the extrahepatic biliary ducts are rare. The high recurrence rate following local resection of these benign tumors is well known, but the development of one into a malignant tumor has received little attention. The recurrence 4 years after local excision of a benign periampullary tumor that developed into a well-differentiated papillar adenocarcinoma is described in this case report.

Azathioprine and subacute myelomonocytic leukemia.

The occurrence of subacute myelomonocytic leukemia is reported in a patient who had been treated with azathioprine for six years because of systemic lupus erythematosus. A review of the literature yielded 16 additional patients with non-lymphocytic leukemia after the use of azathioprine.