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Endoscopy in the management of chronic pancreatitis 内镜在慢性胰腺炎治疗中的应用
Clinical Update Pub Date : 2005-07-01 DOI: 10.1016/j.clinup.2005.05.001
John Baillie MB, ChB, FRCP
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引用次数: 2
Endoscopy in the management of chronic pancreatitis 内镜在慢性胰腺炎治疗中的应用
Clinical Update Pub Date : 2005-07-01 DOI: 10.1016/J.CLINUP.2005.05.001
J. Baillie
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引用次数: 2
The role of endoscopy in triage of patients with upper-GI bleeding 内镜在上消化道出血患者分诊中的作用
Clinical Update Pub Date : 2005-04-01 DOI: 10.1016/j.clinup.2005.02.001
John G. Lee MD
{"title":"The role of endoscopy in triage of patients with upper-GI bleeding","authors":"John G. Lee MD","doi":"10.1016/j.clinup.2005.02.001","DOIUrl":"10.1016/j.clinup.2005.02.001","url":null,"abstract":"<div><h3>Commentary</h3><p>In the United States, upper GI (UGI) bleeding is a common clinical problem requiring more than 300,000 hospitalizations annually. Changes in practice over the last 10 years show that hospitalization days have significantly decreased and that the majority of patients with UGI bleeding undergo endoscopy<span> within 24 hours of admission. Of these endoscopies, 20% to 35% include endoscopic hemostatic<span> therapy. Early endoscopy (within 24 hours of hospital admission) has a greater impact than later endoscopy on length of hospital stay and requirements for blood transfusion. Dr. Lee discusses the value of preadmission endoscopy as a triage tool. The prognostic accuracy of the endoscopic results is sufficient to safely prevent hospitalization for a large number of patients.</span></span></p><p>Grace Elta, MD</p><p>Editor</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"12 4","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.clinup.2005.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81916644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Effects of nonsteroidal anti-inflammatory drugs, including COX-2 specific inhibitors, on the GI tract 非甾体抗炎药，包括COX-2特异性抑制剂，对胃肠道的影响
Clinical Update Pub Date : 2005-01-01 DOI: 10.1016/j.clinup.2004.10.001
James M. Scheiman MD
{"title":"Effects of nonsteroidal anti-inflammatory drugs, including COX-2 specific inhibitors, on the GI tract","authors":"James M. Scheiman MD","doi":"10.1016/j.clinup.2004.10.001","DOIUrl":"10.1016/j.clinup.2004.10.001","url":null,"abstract":"<div><h3>Commentary</h3><p>Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause adverse GI effects, e.g., dyspepsia (persistent pain or discomfort in the upper abdomen), and serious complications, e.g., bleeding and perforation. Although the probability is low that any individual user will suffer a complication, the huge patient exposure translates into a major health care problem. Dr. Scheiman presents a thoughtful review on the GI effects of NSAIDs, low-dose aspirin, COX-2 inhibitors, and the combination of more than one of these therapies. The recent withdrawal of rofecoxib from the market because of an increased risk of thrombotic cardiovascular events should lead clinicians to carefully consider whether this class of agents designed to reduce GI adverse events is appropriate for their patients, especially those with underlying cardiovascular risk. Dr. Scheiman emphasizes that because aspirin use substantially reduces the GI benefit of COX-2 inhibitors, alternative strategies to reduce GI toxicity should be used.</p><p>Grace Elta, MD</p><p>Editor</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"12 3","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.clinup.2004.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87577246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Ten frequently asked questions about endoscopic therapy for gastroesophageal reflux disease 胃食管反流病内镜治疗的十个常见问题
Clinical Update Pub Date : 2004-10-01 DOI: 10.1016/j.clinup.2004.07.001
George Triadafilopoulos MD
{"title":"Ten frequently asked questions about endoscopic therapy for gastroesophageal reflux disease","authors":"George Triadafilopoulos MD","doi":"10.1016/j.clinup.2004.07.001","DOIUrl":"10.1016/j.clinup.2004.07.001","url":null,"abstract":"<div><h3>Commentary</h3><p><span>GERD<span> is the third most common GI disorder in the United States, affects 19 million US adults, and accounts annually for 4,590,000 outpatient visits and 96,000 hospitalizations, amounting to $19 billion in annual costs. The majority of patients have complete relief of symptoms on long-term medical therapy with proton pump inhibitors. However, as much as 20% continue to have a detriment in quality of life scores caused by GERD symptoms. These refractory patients, or patients who do not want to take long-term medications, may benefit from the plethora of new </span></span>endoscopic therapies for GERD. Although long-term follow-up and sham-controlled studies are, in general, not yet available, Dr. Triadafilopoulos reviews the currently available techniques and offers a unique perspective on their potential role in GERD therapy.</p><p>Grace Elta, MD</p><p>Editor</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"12 2","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.clinup.2004.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79875482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Idiopathic acute pancreatitis: role of ERCP in diagnosis and therapy 特发性急性胰腺炎:ERCP在诊断和治疗中的作用
Clinical Update Pub Date : 2004-07-01 DOI: 10.1016/j.clinup.2004.04.001
Stuart Sherman MD
{"title":"Idiopathic acute pancreatitis: role of ERCP in diagnosis and therapy","authors":"Stuart Sherman MD","doi":"10.1016/j.clinup.2004.04.001","DOIUrl":"10.1016/j.clinup.2004.04.001","url":null,"abstract":"<div><h3>Commentary</h3><p>A cause for acute pancreatitis is not identified in 10% to 30% of patients after careful history, physical examination, laboratory testing, and radiologic evaluation. These patients are conventionally classified as having idiopathic acute pancreatitis (IAP). Patients with recurrent episodes of IAP are diagnosed with idiopathic acute recurrent pancreatitis<span> (IARP). IAP and IARP are challenging clinical problems for the physician and often frustrating for the patient. Dr. Stuart Sherman has reviewed the role of ERCP and ancillary endoscopic techniques in the evaluation and therapy of these patients.</span></p><p>Grace Elta, MD</p><p>Editor</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"12 1","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.clinup.2004.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77920353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Diagnostic approach for dysphagia 吞咽困难的诊断方法
Clinical Update Pub Date : 2004-04-01 DOI: 10.1016/j.clinup.2004.01.001
David A. Katzka MD, Michael L. Kochman MD, FACP
{"title":"Diagnostic approach for dysphagia","authors":"David A. Katzka MD,&nbsp;Michael L. Kochman MD, FACP","doi":"10.1016/j.clinup.2004.01.001","DOIUrl":"10.1016/j.clinup.2004.01.001","url":null,"abstract":"<div><h3>Commentary</h3><p><span><span>Dysphagia is a common esophageal symptom with nearly 1 in 5 subjects older than 50 years describing this symptom in </span>epidemiologic surveys. It is the second most common indication for upper </span>endoscopy in the United States. There is a myriad list of possible etiologies for dysphagia. Consequently, a systematic approach to the differential diagnosis resulting in a well planned investigation is important. As described by Drs. Katzka and Kochman, a carefully obtained medical history is the initial step. Upper endoscopy is almost always indicated as part of the evaluation and treatment.</p><p>Grace Elta, MD</p><p>Editor</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"11 4","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.clinup.2004.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75376136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The role of endoscopy in irritable bowel syndrome 内镜检查在肠易激综合征中的作用
Clinical Update Pub Date : 2004-01-01 DOI: 10.1016/S1070-7212(03)00005-8
Brooks D. Cash MD , William D. Chey MD, FACG, FACP
{"title":"The role of endoscopy in irritable bowel syndrome","authors":"Brooks D. Cash MD ,&nbsp;William D. Chey MD, FACG, FACP","doi":"10.1016/S1070-7212(03)00005-8","DOIUrl":"10.1016/S1070-7212(03)00005-8","url":null,"abstract":"<div><h3>Commentary</h3><p><span>Irritable bowel syndrome (IBS) is the most common condition encountered in general gastroenterology practice. IBS has protean manifestations but is typically characterized by abdominal pain, bloating, and disturbed defecation. The prevalence of IBS is estimated to be between 14% and 24% in women and 5% and 19% in men in the United States and Britain and is responsible for 2.4 to 3.5 million physician visits per year. The estimated total direct cost associated with IBS was $1.6 billion in 1998 with medication costs and the costs associated with diagnostic testing comprising the largest components of this estimate. Drs Cash and Chey focus on the role of </span>endoscopy in a cost-effective diagnostic evaluation of IBS.</p><p>Grace Elta, MD</p><p>Editor</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"11 3","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-7212(03)00005-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76635788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of endoscopy in the evaluation and management of patients with suspected pancreatic malignancy 内镜在疑似胰腺恶性肿瘤患者的评估和治疗中的作用
Clinical Update Pub Date : 2003-10-01 DOI: 10.1016/S1070-7212(03)00004-6
Todd H Baron MD , Shawn Mallery MD , Grace Elta MD (Editor)
{"title":"The role of endoscopy in the evaluation and management of patients with suspected pancreatic malignancy","authors":"Todd H Baron MD ,&nbsp;Shawn Mallery MD ,&nbsp;Grace Elta MD (Editor)","doi":"10.1016/S1070-7212(03)00004-6","DOIUrl":"10.1016/S1070-7212(03)00004-6","url":null,"abstract":"<div><h3>Commentary</h3><p><span><span>Pancreatic cancer<span> is the second most frequent gastrointestinal malignancy with approximately 29,000 new cases occurring annually in the United States. Almost all of these patients will die from the disease, making pancreatic cancer the fourth leading cause of cancer death for both men and women. Since surgical resection of the tumor offers the only chance for a cure, modalities for early diagnosis and accurate preoperative staging have continued to evolve. In this review, Drs. Mallery and Baron discuss the role of new diagnostic modalities including helical or multi-detector CT scan<span>, endoscopic ultrasound (EUS), EUS-guided fine needle aspirate, and MRI, </span></span></span>MRCP<span>, and MR angiography. </span></span>ERCP is now primarily relegated to a therapeutic palliative role in inoperable patients. A clinical management algorithm for patients with suspected pancreatic cancer is provided.</p></div>","PeriodicalId":100280,"journal":{"name":"Clinical Update","volume":"11 2","pages":"Pages 1-4"},"PeriodicalIF":0.0,"publicationDate":"2003-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-7212(03)00004-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82718575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 39
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