Reviews in gastroenterological disorders最新文献_第8页

TNF-alpha antagonists: benefits beyond remission. tnf - α拮抗剂:益处超越缓解。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Uma Mahadevan

引用次数: 0

Medical therapy for gastroesophageal reflux disease in 2007. 2007年胃食管反流病的药物治疗。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Philip O Katz

引用次数: 0

Treatment of diarrhea in patients with inflammatory bowel disease: concepts and cautions. 炎症性肠病患者腹泻的治疗:概念和注意事项。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Shamita B Shah, Stephen B Hanauer

{"title":"Treatment of diarrhea in patients with inflammatory bowel disease: concepts and cautions.","authors":"Shamita B Shah, Stephen B Hanauer","doi":"","DOIUrl":"","url":null,"abstract":"Diarrhea continues to be a prevalent symptom in patients with inflammatory bowel disease (IBD), requiring a wide differential diagnosis to define the pathophysiologic mechanisms in individual patients. It is essential that physicians properly evaluate complaints of diarrhea by assessing both patient symptoms and potential physiologic impacts on fluid and electrolyte status. Underlying mechanisms of diarrhea with IBD are the location, extent, and severity of inflammation; malabsorption; altered motility; and iatrogenic causes such as medications, diet, and antibiotic-associated colitis (eg, Clostridium difficile). When treating diarrhea, physicians need to control inflammatory activity using appropriate treatment algorithms. Therapies include aminosalicylates, corticosteroids, immune modifiers, and, most recently, biologic treatment. Other medications, including loperamide, diphenoxylate, codeine sulfate, and tinctures of opium, slow motility and increase the absorption of fluids and nutrients. For iatrogenic issues, medications that cause diarrhea should be withdrawn and individual diets modified. Not all diarrheas in the IBD patient are the same; therefore, it is essential to tailor therapies according to presumed etiologies. Antidiarrheal agents are not recommended in extremely ill patients and those with known hypersensitivity or evidence of obstruction or colonic dilation, fever, or abdominal tenderness. Concomitant use of loperamide with diphenoxylate and atropine should be avoided in early pregnancy.","PeriodicalId":21173,"journal":{"name":"Reviews in gastroenterological disorders","volume":"7 Suppl 3 ","pages":"S3-10"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40837399","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

Fresh perspectives in chronic constipation and other functional bowel disorders. 慢性便秘和其他功能性肠道疾病的新视角。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Brooks D Cash, Eugene Chang, Nicholas J Talley, Arnold Wald

引用次数: 0

Management of diarrhea in clinical practice: strategies for primary care physicians. 临床实践中腹泻的管理:初级保健医生的策略。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Lawrence R Schiller

引用次数: 0

The A's and B's of vaccine-preventable hepatitis: improving prevention in high-risk adults. 疫苗可预防肝炎的A级和B级:改善高危成人的预防。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Edward C Oldfield, Emmet B Keeffe

{"title":"The A's and B's of vaccine-preventable hepatitis: improving prevention in high-risk adults.","authors":"Edward C Oldfield, Emmet B Keeffe","doi":"","DOIUrl":"","url":null,"abstract":"Acute hepatitis A and acute hepatitis B are associated with significant morbidity, time away from work or usual activities, substantial cost to the healthcare system, and some mortality. Despite the availability of vaccines against hepatitis B and hepatitis A since 1981 and 1995, respectively, and a combined hepatitis A and B vaccine since 2001, immunization rates against these vaccine-preventable diseases are appallingly low. In particular, several groups of adults, such as men who have sex with men, heterosexuals with multiple partners, injection drug users, persons with human immunodeficiency virus infection, travelers to endemic areas, and persons with chronic liver disease, are at particularly high risk for acute hepatitis A and B or for a more severe illness or a higher rate of chronicity in the case of hepatitis B. Studies have confirmed that hepatitis A and hepatitis B vaccines are safe and immunogenic in patients in these populations, although patients with more advanced disease may respond less well. These observations have led to the recommendation that patients falling into the above risk groups undergo hepatitis A and B vaccination early in the natural history of their underlying risk behavior or diseases. Vaccination rates are low in clinical practice, and public health and educational programs are needed to overcome barriers to facilitate timely implementation of these recommendations. The use of a combined vaccination, possibly using an accelerated administration schedule, provides convenience and may increase compliance.","PeriodicalId":21173,"journal":{"name":"Reviews in gastroenterological disorders","volume":"7 1","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26231978","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

Endoscopic ultrasound and percutaneous access for endoscopic biliary and pancreatic drainage after initially failed ERCP. 内镜下超声和经皮进入内镜胆道和胰管引流最初失败的ERCP。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Kapil Gupta, Shawn Mallery, David Hunter, Martin L Freeman

{"title":"Endoscopic ultrasound and percutaneous access for endoscopic biliary and pancreatic drainage after initially failed ERCP.","authors":"Kapil Gupta, Shawn Mallery, David Hunter, Martin L Freeman","doi":"","DOIUrl":"","url":null,"abstract":"Although the success rates of endoscopic retrograde cholangiopancreatography (ERCP) in accessing the bile and pancreatic ducts are quite high, failure to achieve duct access still occurs. Options in these cases have traditionally included percutaneous access or open surgical intervention. A combination percutaneous and endoscopic approach (ie, rendezvous procedure) is often used in cases of failed biliary cannulation by ERCP and occasionally for pancreatic duct access. However, this technique often results in complications and is hampered by the difficulty in coordinating schedules between interventional radiologists and endoscopists and the lack of predictability of failed ERCP access. Several groups have described the use of endoscopic ultrasonography (EUS) in accessing the ducts in cases of failed ERCP. This technique has the potential to substantially reduce the need for a percutaneous or surgical approach in many cases. This article reviews the nonsurgical methods for accessing the biliary and pancreatic ducts after failure of ERCP as well as the current status and possible future applications of EUS-assisted drainage techniques.","PeriodicalId":21173,"journal":{"name":"Reviews in gastroenterological disorders","volume":"7 1","pages":"22-37"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26231979","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

Biologic therapy in Crohn's disease: review of the evidence. 克罗恩病的生物治疗:证据综述

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Edward V Loftus

引用次数: 0

Clinical perspectives in Crohn's disease. Turning traditional treatment strategies on their heads: current evidence for "step-up" versus "top-down". 克罗恩病的临床观点颠覆传统的治疗策略:目前的证据是“加强”还是“自上而下”。

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Stephen B Hanauer

{"title":"Clinical perspectives in Crohn's disease. Turning traditional treatment strategies on their heads: current evidence for \"step-up\" versus \"top-down\".","authors":"Stephen B Hanauer","doi":"","DOIUrl":"","url":null,"abstract":"The current Crohn's disease treatment algorithm involves a \"step-up\" approach in which conventional medications such as corticosteroids are given first and anti-tumor necrosis factor-a (TNF-a) agents are reserved for refractory cases. Although this approach may seem to be cost-efficient, recent studies have shown that \"top-down\" therapy using anti-TNF-a agents in newly diagnosed patients improves long-term rates of mucosal healing, a therapeutic endpoint that correlates with reduced hospitalizations and surgeries, thereby reducing overall costs and enhancing patients' quality of life. Another reason the step-up approach has been favored over the top-down is concern about side effects; however, a multivariate logistic regression analysis of patients treated with or without infliximab showed no differences in mortality, serious infections, or malignancies between the 2 groups. Moreover, newer anti-TNF-a agents, such as adalimumab and certolizumab pegol, have the potential to reduce the risk of immunogenicity and the associated infusion reactions and loss of response, as well as reducing autoimmunity associated with infliximab therapy. The potential advantages of \"reversing\" our current therapeutic pyramid/algorithm for the treatment of Crohn's disease include early disease stabilization and disease modification, minimization of complications such as strictures and fistulae that lead to the need for surgery, reduction of postoperative recurrence, and avoidance of the ubiquitous complications of corticosteroid therapy.","PeriodicalId":21173,"journal":{"name":"Reviews in gastroenterological disorders","volume":"7 Suppl 2 ","pages":"S17-22"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26231986","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

Empiric treatment of traveler's diarrhea: azithromycin emerging as new drug of choice? 旅行者腹泻的经验性治疗:阿奇霉素成为首选新药?

Reviews in gastroenterological disorders Pub Date : 2007-01-01

Edward C Oldfield

引用次数: 0