Clinical Medicine Insights. Gastroenterology最新文献_第3页

Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile. 利福昔明:肠易激综合征的最新治疗前沿，作用机制和临床概况。

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-08-31 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217728905

Kamesh Gupta, Harparam Singh Ghuman, Shivani Vijay Handa

{"title":"Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile.","authors":"Kamesh Gupta, Harparam Singh Ghuman, Shivani Vijay Handa","doi":"10.1177/1179552217728905","DOIUrl":"https://doi.org/10.1177/1179552217728905","url":null,"abstract":"Background: Irritable bowel syndrome is classified as a functional gastrointestinal disorder with the primary symptom of abdominal pain in conjunction with bloating and bowel movement disorder. It affects up to 15% of the world's population. Among its subtypes, the most common is diarrhoea predominant. However, the current treatment options for diarrhoea-predominant irritable bowel syndrome have had not very promising results; most, such as antispasmodics, only provide partial symptomatic relief. Treatment with antidepressants and alosetron (a 5HT3 antagonist) has shown the most promise to date. The latest drug to be approved for the treatment of irritable bowel syndrome-diarrhoea is rifaximin, which was approved in May 2015. It is a minimally absorbed antibiotic that is used to change the gut microbiota. Small intestinal bacterial overgrowth is one of the causes suggested for irritable bowel syndrome, particularly for the diarrhoea-predominant type. There are various methods for detecting bacterial overgrowth, the simplest of which is breath tests. Rifaximin has been shown to be of benefit to these patients.Purpose: The purpose of the study is to discuss the potential mechanism of action of rifaximin, a minimally absorbed antibiotic. In addition, we evaluate the various clinical trials undertaken to study the efficacy and safety profile of rifaximin.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"10 ","pages":"1179552217728905"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179552217728905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35396857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis. 成人功能性便秘患者结肠转运时间和便秘患者评估的规范值:系统综述与荟萃分析。

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-08-31 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217729343

Larry E Miller, Alvin Ibarra, Arthur C Ouwehand

{"title":"Normative Values for Colonic Transit Time and Patient Assessment of Constipation in Adults With Functional Constipation: Systematic Review With Meta-Analysis.","authors":"Larry E Miller, Alvin Ibarra, Arthur C Ouwehand","doi":"10.1177/1179552217729343","DOIUrl":"https://doi.org/10.1177/1179552217729343","url":null,"abstract":"Availability of normative patient outcome data may assist in designing experiments and estimating sample sizes. The purpose of this review was to determine normative ranges for colonic transit time (CTT), Patient Assessment of Constipation-Symptoms (PAC-SYM), and Patient Assessment of Constipation-Quality of Life (PAC-QOL) in adults diagnosed with functional constipation per Rome III guidelines. Pooled estimates were derived from random-effects meta-analysis. Meta-regression was used to explore sources of heterogeneity among studies. A total of 24 studies (3786 patients) were included in the review. In 10 studies with 1119 patients, pooled CTT was 58 hours (95% confidence interval [CI]: 50-65 hours). Publication bias was not evident (Egger P = .51); heterogeneity was high (I2 = 92%, P < .001). In meta-regression, geographical location explained 57% of the between-study variance, with CTT significantly longer in studies conducted in Europe (71 hours) compared with Asia (49 hours) or the Americas (44 hours). In 9 studies with 2061 patients, pooled PAC-SYM was 1.70 (95% CI: 1.58-1.83). Publication bias was not evident (Egger P = .44). Heterogeneity was high (I2 = 90%, P < .001); however, no study or patient factor influenced PAC-SYM in meta-regression. In 12 studies with 1805 patients, pooled PAC-QOL was 1.97 (95% CI: 1.70-2.24). Publication bias was not evident (Egger P = .28); heterogeneity was high (I2 = 98%, P < .001). In meta-regression, age explained 52% of the between-study variance, with older age associated with lower PAC-QOL scores. Overall, in adults diagnosed with functional constipation per Rome III criteria, significant heterogeneity in CTT, PAC-SYM, and PAC-QOL exists among studies. Variability among studies may be explained by geography and patient factors.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"11 ","pages":"1179552217729343"},"PeriodicalIF":0.0,"publicationDate":"2017-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179552217729343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35396858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Corrigendum. 勘误表。

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-07-26 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217722589

引用次数: 0

Understanding Celiac Disease From Genetics to the Future Diagnostic Strategies. 从遗传学到未来诊断策略理解腹腔疾病。

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-07-07 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217712249

Carolina Salazar, Jennyfer M García-Cárdenas, César Paz-Y-Miño

引用次数: 9

The Aftermath of a Hepatic Artery Aneurysm-A Rare Etiology of Biliary Obstruction! 肝动脉瘤的后遗症——胆道梗阻的罕见病因!

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-06-08 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217711430

Catherine Linzay, Abhishek Seth, Kunal Suryawala, Ankur Sheth, Moheb Boktor, John Bienvenu, Robby Rahim, Guillermo P Sangster, Paul A Jordan

{"title":"The Aftermath of a Hepatic Artery Aneurysm-A Rare Etiology of Biliary Obstruction!","authors":"Catherine Linzay, Abhishek Seth, Kunal Suryawala, Ankur Sheth, Moheb Boktor, John Bienvenu, Robby Rahim, Guillermo P Sangster, Paul A Jordan","doi":"10.1177/1179552217711430","DOIUrl":"https://doi.org/10.1177/1179552217711430","url":null,"abstract":"Background: Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported.Case presentation: A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin. Imaging showed a large HAA. Patient was transferred to our hospital where an endoscopic retrograde cholangiopancreatography with biliary stenting was performed. This was followed by coil embolization of the HAA with improvement in symptoms and liver chemistries.Conclusions: Most clinicians agree that management of HAA is highly variable and depends on clinical presentation and anatomic location. Biliary stenting provides temporary relief for patients with obstructive jaundice. Definitive options include open aneurysmal repair versus endovascular therapy. Hepatic artery aneurysms represent a significant risk for hemorrhage and therefore must be addressed promptly once discovered.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"10 ","pages":"1179552217711430"},"PeriodicalIF":0.0,"publicationDate":"2017-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179552217711430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35105253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Functional Budd-Chiari Syndrome Associated With Severe Polycystic Liver Disease. 与严重多囊性肝病相关的功能性布-恰里综合征

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-06-07 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217713003

Precil Diego Miranda de Menezes Neves, Bruno Eduardo Pedroso Balbo, Elieser Hitoshi Watanabe, Vinicius Rocha-Santos, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque, Luiz Fernando Onuchic

{"title":"Functional Budd-Chiari Syndrome Associated With Severe Polycystic Liver Disease.","authors":"Precil Diego Miranda de Menezes Neves, Bruno Eduardo Pedroso Balbo, Elieser Hitoshi Watanabe, Vinicius Rocha-Santos, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque, Luiz Fernando Onuchic","doi":"10.1177/1179552217713003","DOIUrl":"https://doi.org/10.1177/1179552217713003","url":null,"abstract":"A 50-year-old woman with end-stage renal disease secondary to autosomal dominant polycystic kidney disease was referred to a quaternary care center due to significantly increased abdominal girth. Her physical examination revealed tense ascites and abdominal collateral veins. A 10-L paracentesis improved abdominal discomfort and disclosed a transudate, suggestive of portal hypertension. A computed tomographic scan revealed massive hepatomegaly caused by multiple cysts of variable sizes, distributed throughout all hepatic segments. Contrast-enhanced imaging uncovered extrinsic compression of hepatic and portal veins, resulting in functional Budd-Chiari syndrome and portal hypertension. Although image-guided drainage followed by sclerosis of dominant cysts could potentially lead to alleviation of the extrinsic compression, the associated significant risk of cyst hemorrhage and infection precluded this procedure. In this scenario, the decision was to submit the patient to a liver-kidney transplantation. After 1 year of this procedure, the patient maintains normal liver and kidney function and refers significant improvement in quality of life.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"10 ","pages":"1179552217713003"},"PeriodicalIF":0.0,"publicationDate":"2017-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179552217713003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35086749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Omeprazole-Domperidone Fixed Dose Combination vs Omeprazole Monotherapy: A Phase 4, Open-Label, Comparative, Parallel Randomized Controlled Study in Mild to Moderate Gastroesophageal Reflux Disease. 奥美拉唑-多潘立酮固定剂量联合疗法与奥美拉唑单一疗法的对比研究：一项针对轻度至中度胃食管反流病的 4 期、开放标签、比较性、平行随机对照研究。

Clinical Medicine Insights. Gastroenterology Pub Date : 2017-05-31 eCollection Date: 2017-01-01 DOI: 10.1177/1179552217709456

K Y Marakhouski, G A Karaseva, D N Ulasivich, Y Kh Marakhouski

{"title":"Omeprazole-Domperidone Fixed Dose Combination vs Omeprazole Monotherapy: A Phase 4, Open-Label, Comparative, Parallel Randomized Controlled Study in Mild to Moderate Gastroesophageal Reflux Disease.","authors":"K Y Marakhouski, G A Karaseva, D N Ulasivich, Y Kh Marakhouski","doi":"10.1177/1179552217709456","DOIUrl":"10.1177/1179552217709456","url":null,"abstract":"Aim: To compare the efficacy and safety of omeprazole-domperidone combination vs omeprazole monotherapy in gastroesophageal reflux disease (GERD).Methods: In a comparative, randomized controlled, phase 4 study, outpatients with GERD were randomly allocated to either group 1 (omeprazole 20 mg + domperidone 30 mg) or group 2 (omeprazole 20 mg) in an equal ratio; 2 capsules daily in the morning were administered for 8 weeks.Results: Sixty patients were enrolled. Esophagitis reversal was observed in 92% patients in group 1 vs 65.2% in group 2. Approximately, 83.3% patients in group 1 vs 43.3% patients in group 2 demonstrated full cupping of reflux symptoms at 8 weeks. Combined therapy resulted in significantly longer period of heartburn-free days (23 vs 12 days on omeprazole). There were no safety concerns.Conclusions: Omeprazole-domperidone combination was more effective than omeprazole alone in providing complete cupping of reflux symptoms and healing of esophagitis in patients with GERD. Both the treatments were well tolerated with few reports of adverse events.Trial registration: This trial is registered with http://clinicaltrials.gov, number NCT02140073.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"10 ","pages":"1179552217709456"},"PeriodicalIF":0.0,"publicationDate":"2017-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/0b/10.1177_1179552217709456.PMC5457029.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35083195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary Esophageal Intramural Squamous Cell Carcinoma Masquerading as a Submucosal Tumor: A Rare Presentation of a Common Disease 伪装为粘膜下肿瘤的原发性食管壁内鳞状细胞癌:一种罕见的常见病

Clinical Medicine Insights. Gastroenterology Pub Date : 2016-09-01 DOI: 10.4137/CGast.S40605

Nikhil Sonthalia, Samit Jain, R. Surude, V. Pawar, Suhas Udgirkar, P. Rathi

{"title":"Primary Esophageal Intramural Squamous Cell Carcinoma Masquerading as a Submucosal Tumor: A Rare Presentation of a Common Disease","authors":"Nikhil Sonthalia, Samit Jain, R. Surude, V. Pawar, Suhas Udgirkar, P. Rathi","doi":"10.4137/CGast.S40605","DOIUrl":"https://doi.org/10.4137/CGast.S40605","url":null,"abstract":"Esophageal squamous cell carcinoma (ESCC) is the commonest primary malignant esophageal tumor, which typically presents as endoscopically visible surface mucosal ulcerations, irregularities, or polyploidal masses. We here report a rare case of primary ESCC with completely intramural growth under a normal looking intact nondysplastic surface squamous epithelium disguising as a submucosal tumor. Upper gastrointestinal endoscopy-guided mucosal biopsy was negative for malignancy. Endoscopic ultrasound (EUS) revealed a heteroechoic solid mass originating from the muscularis propria of the distal esophagus. Cytological study of EUS-guided fine needle aspiration from the mass was suggestive of squamous cell carcinoma, which was confirmed on immunohistochemistry. There was no evidence of metastatic origin of this tumor or continuous cancer involvement from the surrounding structures, including the head, neck, and lungs on bronchoscopy, computed tomography scan, and positron emission tomography scan. Exclusive intramural squamous cell carcinoma with normal overlying mucosa is an exceedingly rare presentation of primary ESCC with only four cases reported in the literature so far. A high index of suspicion is required by the gastroenterologists and pathologists in diagnosing these cases as these tumors closely mimic the mesenchymal submucosal tumors such as lipoma, leiomyoma, and gastrointestinal stromal tumors. EUS is an indispensable tool in making a preoperative diagnosis and therapeutic decision making.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"27 1","pages":"63 - 66"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72783699","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 and Therapeutic Approaches to Hepatocellular Carcinoma: Understanding the Barcelona Clínic Liver Cancer Protocol 肝细胞癌的诊断和治疗方法:了解巴塞罗那Clínic肝癌协议

Clinical Medicine Insights. Gastroenterology Pub Date : 2016-09-01 DOI: 10.4137/CGast.S30190

J. Soldera, S. Balbinot, R. A. Balbinot, A. Cavalcanti

引用次数: 10

The Role of Laboratory Tests in Crohn’s Disease 实验室检查在克罗恩病中的作用

Clinical Medicine Insights. Gastroenterology Pub Date : 2016-08-18 DOI: 10.4137/CGast.S38203

M. Cappello, G. Morreale

引用次数: 30