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[Extraintestinal manifestations in inflammatory bowel disease]. [炎症性肠病的肠外表现]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Stephan R Vavricka
{"title":"[Extraintestinal manifestations in inflammatory bowel disease].","authors":"Stephan R Vavricka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic inflammatory bowel diseases (IBD) are inflammatory gastrointestinal disorders that are not limited to the gastrointestinal tract. Many different organ systems may be involved, which makes IBD a systemic disease. The most common extraintestinal manifestations (EIM) include musculoskeletal, ophthalmological, dermatological, and hepato-biliary disorders. EIM considerably contribute to the morbidity of patients with IBD, and they limit quality of life of affected patients. Due to the diversity of the organ systems involved, care should be provided by an interdisciplinary team. Early detection of EIM allows targeted therapy and reduces overall morbidity. Of importance is the fact that EIM can occur in up to 25% of all IBD patients before the onset of the first Crohn's episode or ulcerative colitis. Therefore, all doctors, especially dermatologists, ophthalmologists and rheumatologists should be aware of this possible association between EIM and the simultaneous occurrence of intestinal symptoms.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 9","pages":"393-397"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811674","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
[Overview and therapy update Crohn's disease]. [克罗恩病概述和最新疗法]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Roy Frei, Benjamin Misselwitz
{"title":"[Overview and therapy update Crohn's disease].","authors":"Roy Frei, Benjamin Misselwitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease (CD) is a chronic inflammatory bowel disease that can affect the entire gastrointestinal tract. The pathophysiology of CD includes a disrupted interplay of intestinal bacteria, the intestinal immune system and the intestinal surface in genetically susceptible individuals, which remains incompletely understood. Conventional therapies include steroids, but numerous advanced therapies are also available. Three tumor necrosis factor (TNF) inhibitors (infliximab, adalimumab and certolizumab pegol (Switzerland)) have been approved for MC. Additional treatment options include the interleukin (IL)-12/23 inhibitors ustekinumab and the integrin inhibitors vedolizumab. With risankizumab, a first selective IL-23 inhibitor for CD has been approved by the EMA in 2022. Moreover, the Janus kinase-1 inhibitor upadacitinib has been available for the treatment of CD in the EU since 2023. For localized CD, elective surgical resection also remains a valid option with good long-term outcomes. Perianal and fistulizing CD are difficult to treat and require a close interdisciplinary collaboration between gastroenterologists and colorectal surgeons. Surgical fistula treatment with curative intent should only be performed in well-controlled CD. The recent increase in therapeutic options in CD is encouraging, since more safe and effective therapies are now available to patients. Nevertheless, CD remains an incurable disease and so far, for all existing treatments only a fraction of patients responds to the therapy. Therefore, the development of new therapies should continue.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 9","pages":"378-385"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811711","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
[Overview and update on treatment in ulcerative colitis]. [溃疡性结肠炎治疗概述与更新]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Laura Rossier, Christoph Matter
{"title":"[Overview and update on treatment in ulcerative colitis].","authors":"Laura Rossier, Christoph Matter","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis is characterized by a chronic intestinal inflammation limited to the mucosa of the colon, of variable proximal extent. Main symptoms are diarrhea, possibly bloody, and abdominal pain. It evolves with phases of relapse and remission. The diagnosis of ulcerative colitis is made based on clinical, endoscopic, and histologic findings. Currently, the various drug treatment options act by, among other things, reducing the activity of the immune system locally or systemically. In mild to moderate forms, 5-ASA remains the mainstay of both induction and maintenance treatment. In more severe flares, cortisone is the treatment of choice. To limit the prolonged/repeated intake of corticosteroids, there are several options of biologics with distinct ranges of action and safety profiles for inducing and/or maintaining remission. Therapeutic goals are evolving and go beyond achieving clinical remission. Endoscopic and histological remission are new targets to further improve quality of life and limit long-term complications, such as colorectal cancer.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 9","pages":"386-392"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811712","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
[Modern endoscopy in inflammatory bowel disease]. [炎症性肠病的现代内窥镜检查]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Samuel Truniger, Remus Frei, Stephan Brand
{"title":"[Modern endoscopy in inflammatory bowel disease].","authors":"Samuel Truniger, Remus Frei, Stephan Brand","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic examinations play a very important role in the diagnosis, progress assessment, and therapy of inflammatory bowel diseases (IBD). This includes not only esophagogastroduodenoscopy, sigmoidoscopy, and ileo-colonoscopy, but also assessment of the small intestine. The work-up of the small intestine is primarily carried out using non-invasive techniques (intestinal ultrasound, magnetic resonance enterography (MRE)). However, if the diagnosis remains unclear, a histological proof is necessary or an endoscopic intervention is required, capsule endoscopy and balloon-assisted enteroscopy are used. Furthermore, endoscopic ultrasound is available to assess perianal fistulizing Crohn's disease, and ERCP (endoscopic retrograde cholangiopancreatography) is used in certain patients with IBD-associated primary sclerosing cholangitis (PSC). Given the high resolution of modern endoscopes and the availability of chromoendoscopy, dysplastic lesions are detected earlier and can often be resected endoscopically. In addition, short strictures/stenoses can be treated using balloon dilatations.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 9","pages":"411-416"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811706","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
Chronisch entzündliche Darmerkrankungen: eine Einführung. 慢性炎症性肠病：简介。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Emanuel Burri
{"title":"Chronisch entzündliche Darmerkrankungen: eine Einführung.","authors":"Emanuel Burri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 9","pages":"377"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811713","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
[Modern surgery for inflammatory bowel disease]. [炎症性肠病的现代外科手术]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Georg Henniger, Raffaele Galli, Robert Rosenberg
{"title":"[Modern surgery for inflammatory bowel disease].","authors":"Georg Henniger, Raffaele Galli, Robert Rosenberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the advances in the medical management, especially biologics, there are still clear indications for operative management of IBD. For Crohn's disease, surgical therapy plays an important role after failure of medical management and for treatment of complications. In recent years, however, there has been a change in the treatment philosophy of patients with isolated involvement of the ileocecal region, and for selected patients, primary surgical resection appears to be an equivalent treatment alternative to therapy with biologics. In ulcerative colitis, surgery offers the only curative option. In severe acute colitis, surgery is indicated when conservative treatment is not effective and/or when there is a risk of colonic perforation. Indications for elective surgery are failure of conservative therapy and malignant transformation. The ileoanal J-pouch reconstruction is the standard procedure after restorative proctocolectomy with excellent functional long-term results. The increasing complexity of indications and minimally invasive surgical techniques, as well as the demanding perioperative treatment, led to an increasing specialization in the surgical treatment of IBD patients, with IBD-surgeons collaborating as a team with gastroenterologists to optimize the outcome of IBD-patients.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 9","pages":"417-422"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811707","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
[Eosinophilic oesophagitis and eosinophilic gastrointestinal diseases]. [嗜酸性粒细胞食管炎和嗜酸性粒细胞胃肠病]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-12-01
Catrina Waldegg, Thomas Greuter
{"title":"[Eosinophilic oesophagitis and eosinophilic gastrointestinal diseases].","authors":"Catrina Waldegg, Thomas Greuter","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic oesophagitis (EoE) was first described as an orphan disease in the 1990s, but its incidence and prevalence has increased dramatically in the last 20 years. EoE is now the most common cause of dysphagia in young adulthood. EoE is diagnosed endoscopically (with biopsies taken from the oesophagus). Treatment options consist of dietary measures and medications. The latter include PPI (as an off-label medication) and the approved drugs Jorveza (budesonide, topical cortisone preparation) and the monoclonal antibody Dupixent (dupilumab, subcutaneous). The response to therapy is high and the long-term outcome, if treated early, is excellent. However, the disease often remains undetected, mostly due to compensation mechanisms on the part of the patients. Much rarer than EoE are the non-EoE eosinophilic gastrointestinal diseases (EGIDs), in which the eosinophilic tissue infiltration is found in gastrointestinal segments distal to the oesophagus. Their clinical presentation is often non-specific. Pathophysiologically, overlaps with EoE are present. Therapies are also analogous to EoE. An increasing prevalence and incidence is to be expected.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"79 9","pages":"423-428"},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811654","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
[Long-term side effects of immune checkpoint inhibition]. [免疫检查点抑制的长期副作用]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-10-01
Helena Marie Stricker, Andreas Wicki
{"title":"[Long-term side effects of immune checkpoint inhibition].","authors":"Helena Marie Stricker, Andreas Wicki","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The use of immune checkpoint inhibitors has fundamentally changed the treatment landscape of solid tumors in recent years. Even in advanced stages or in tumors with historically poor prognosis, such as triple-negative breast cancer, progression-free survival, as well as overall survival of affected individuals, have considerably improved. As a result, the side effects and consequences of therapy, their detection, and treatment are becoming an increasingly important part of patient follow-up.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 8","pages":"367-372"},"PeriodicalIF":0.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399699","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
[Modern cancer therapy and management of side effects]. 【现代癌症治疗与副作用管理】。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-10-01
Marcus Vetter
{"title":"[Modern cancer therapy and management of side effects].","authors":"Marcus Vetter","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong></p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 8","pages":"347"},"PeriodicalIF":0.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399700","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
[Side effects of oncology drugs in elderly patients]. [肿瘤药物对老年患者的副作用]。
IF 0.2
THERAPEUTISCHE UMSCHAU Pub Date : 2023-10-01
Vérène Dougoud-Chauvin
{"title":"[Side effects of oncology drugs in elderly patients].","authors":"Vérène Dougoud-Chauvin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer is a disease of old age with approximately 50% of new cancer cases occurring in humans aged 65 years and older and this number is expected to rise to 58% by 2030. Chemotherapy remains a standard part of cancer treatment, alongside new therapies such as immunotherapy and targeted therapies. However, older patients are at increased risk of chemotherapy-induced toxicity compared to younger adults. Various pharmacological parameters must be taken into account in the oncological treatment of older patients. Assessing age-related conditions that affect tolerability with geriatric evaluation is very important when planning chemotherapy. Several studies have shown that geriatric assessment variables can be used to identify older adults who are most at risk of severe toxicity from chemotherapy. Oral oncological therapies present several advantages. However, they also contain disadvantages, especially in older patients, which can lead to poorer efficiency or earlier discontinuation of therapy. Despite the physiological phenomena of immunosenescence and inflammaging, the data, mainly coming from subgroup analysis of meta-analyses, tends to show that immunotherapy is effective and well-tolerated even in older patients.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 8","pages":"363-366"},"PeriodicalIF":0.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399703","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
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