Continued midazolam versus diphenhydramine in difficult-to-sedate patients: a randomized double-blind trial.

Background And Aims: Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients.

Methods: Patients undergoing elective colonoscopy with moderate sedation were eligible.

Diverticular disease: paradigm shifts in pathogenesis and treatment.

Colonic diverticulosis is one of the most common gastrointestinal conditions affecting the Western world and is recognized as an increasingly common condition since its first description in the 1800s. Despite its widespread prevalence, its exact pathogenesis remains unknown. Additionally, its wide spectrum of clinical manifestations has led to multiple approaches in the management of this disease.

Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis.

Importance: Current guidelines recommend an intravenous bolus dose of a proton pump inhibitor (PPI) followed by continuous PPI infusion after endoscopic therapy in patients with high-risk bleeding ulcers. Substitution of intermittent PPI therapy, if similarly effective as bolus plus continuous-infusion PPI therapy, would decrease the PPI dose, costs, and resource use.

Objective: To compare intermittent PPI therapy with the currently recommended bolus plus continuous-infusion PPI regimen for reduction of ulcer rebleeding.

The symmetrical dimethylarginine post-translational modification of the SmD3 protein is not required for snRNP assembly and nuclear transport.

The SmB, SmD1, and SmD3 proteins have the rare symmetrical dimethylarginine post-translational modification in their C-termini. In this report, we investigate the function of this modification in the assembly and intracellular transport of the SmD3 protein. We show that the elimination of this methylation in the SmD3 protein, by mutating the modified arginines to leucines, does not interfere with the assembly and the nuclear transport of the transiently expressed SmD3 variant.