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A practical approach to nutritional support in liver disease. 肝病患者营养支持的实用方法。
The Gastroenterologist Pub Date : 1995-09-01
M J Levinson
{"title":"A practical approach to nutritional support in liver disease.","authors":"M J Levinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nutritional problems are very common in patients with liver disease. The underlying liver disease will cause anorexia, nausea, and a poor appetite. In addition, alcohol acts as \"cheap calories\" and may be an added problem. Physicians taking care of patients with liver disease often place them on restrictive diets that compound the nutritional problem. Patients must be addressed for both the liver disease and the nutritional problems its treatment may create. One very important fact is that the majority of patients with liver disease will tolerate standard formulas that are much more \"cost-effective\" for the patients. How to calculate caloric and protein needs and how to select certain formulas are addressed. The results that show nutritional support is beneficial in decreasing mortality and morbidity are reviewed.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 3","pages":"234-40"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19517525","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
Twenty-four hour esophageal pH monitoring: technique and application. 24小时食管pH监测技术及应用。
The Gastroenterologist Pub Date : 1995-09-01
K C Trimble, S Douglas, R C Heading
{"title":"Twenty-four hour esophageal pH monitoring: technique and application.","authors":"K C Trimble,&nbsp;S Douglas,&nbsp;R C Heading","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the last three decades, esophageal pH monitoring has progressed from an exclusively laboratory-based physiological research tool to a routine outpatient clinical investigation in patients with one of the most common gastrointestinal disorders. Technological advancement has considerably simplified both the procedure and the interpretation of data obtained, and there is currently reasonable consensus as to the parameters that best discriminate between physiological and pathological gastroesophageal reflux. There remains a need for internationally agreed definitions and standards, particularly with regard to calculation of these parameters, which would improve comparability of future research studies from different centers. Clinical applications of the technique have increased with our enhanced knowledge of the protean clinical manifestations of reflux disease. The advent of potent pharmacotherapy and the recognition of a need for ongoing treatment in many patients will ensure that the most sensitive test for the diagnosis of gastroesophageal reflux disease will remain an essential part of the investigation of upper gastrointestinal symptoms.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 3","pages":"187-98"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19516779","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
Infectious colitides in patients with acquired immunodeficiency syndrome. 获得性免疫缺陷综合征患者的感染性结肠炎。
The Gastroenterologist Pub Date : 1995-09-01
B N Mosenkis, D Simon
{"title":"Infectious colitides in patients with acquired immunodeficiency syndrome.","authors":"B N Mosenkis,&nbsp;D Simon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diarrhea is a common problem in patients with acquired immunodeficiency syndrome (AIDS), and infections of the colon constitute a significant etiology. Cytomegalovirus (CMV) is the most common opportunistic infection of the colon in patients with AIDS, and it can involve any portion of the colon and the gastrointestinal tract. Because CMV is potentially treatable with either ganciclovir or foscarnet, it is important to evaluate endoscopically the entire colon of patients with AIDS with protracted diarrhea and no cause identifiable with routine stool and laboratory tests. In addition to CMV, there are a variety of other viral, bacterial, protozoal, and fungal infections seen in patients with AIDS. A thorough evaluation will help identify these pathogens, and those that are treatable can be given appropriate therapy.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 3","pages":"241-8"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19517526","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
Pediatric gastrointestinal endoscopy. 小儿胃肠内窥镜检查。
The Gastroenterologist Pub Date : 1995-09-01
M Haight, D W Thomas
{"title":"Pediatric gastrointestinal endoscopy.","authors":"M Haight,&nbsp;D W Thomas","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Development of smaller instruments and emergence of pediatric gastroenterology as a legitimate and growing subspecialty have been primary factors involved in effective utilization of gastrointestinal endoscopy in the care of infants and children. Endoscopic gastrointestinal procedures are now common in most major pediatric centers, and they can be safely performed on small infants, including newborns. This review of pediatric endoscopy presents many of the standard techniques that are applied in most pediatric centers in the United States. Some of the important issues and differences between pediatric and adult patients with gastrointestinal diseases are discussed.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 3","pages":"181-6"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19516778","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 antiphospholipid syndrome and ischemic colitis. 抗磷脂综合征与缺血性结肠炎。
The Gastroenterologist Pub Date : 1995-09-01
H N Klestzick, P McPhedran, D Cipolla, W A Berry, M DiCorato, J Denowitz
{"title":"The antiphospholipid syndrome and ischemic colitis.","authors":"H N Klestzick,&nbsp;P McPhedran,&nbsp;D Cipolla,&nbsp;W A Berry,&nbsp;M DiCorato,&nbsp;J Denowitz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 3","pages":"249-56"},"PeriodicalIF":0.0,"publicationDate":"1995-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19517527","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
Diagnosis and therapy of hereditary polyposis syndromes. 遗传性息肉病综合征的诊断与治疗。
The Gastroenterologist Pub Date : 1995-06-01
G D Luk
{"title":"Diagnosis and therapy of hereditary polyposis syndromes.","authors":"G D Luk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The hereditary polyposis syndromes include the adenomatous polyposis syndromes (familial adenomatous polyposis and Gardner syndrome, and Turcot syndrome) and the hamartomatous polyposis syndromes (Peutz-Jeghers syndrome, juvenile polyposis, and Cowden's disease). The adenomatous polyposis syndromes are characterized by numerous adenomatous polyps throughout the entire colon and a spectrum of extracolonic manifestations; they invariably progress to colorectal cancer without appropriate intervention. The hamartomatous polyposis syndromes are characterized by diffuse intestinal or colonic hamartomatous polyps, such as juvenile polyps. Although hamartomatous polyps have virtually no malignant potential, the hamartomatous polyposis syndromes are associated with increased risk of cancer, both within and outside the small intestine and the colon. Diagnosis of symptomatic polyposis is by colonoscopy, but in presymptomatic screening of familial adenomatous polyposis, genetic testing can be effective, and it is becoming increasingly available though research laboratories. Management involves treatment of affected individuals, counseling of patients and their families, screening of at-risk individuals, and surveillance of affected patients for extracolonic cancers. Treatment of adenomatous polyposis is primarily colectomy during the second or third decade. For the hamartomatous polyposis syndromes, surveillance for early cancers and their excision remain the only practical, although not totally satisfactory, approaches.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 2","pages":"153-67"},"PeriodicalIF":0.0,"publicationDate":"1995-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18646811","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
Cyclosporine: indications and use in gastrointestinal diseases. 环孢素:胃肠道疾病的适应症和应用。
The Gastroenterologist Pub Date : 1995-06-01
P P Purdum, A J Sanyal
{"title":"Cyclosporine: indications and use in gastrointestinal diseases.","authors":"P P Purdum,&nbsp;A J Sanyal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cyclosporine is the most important drug used in transplant medicine, and it has revolutionized the field of organ transplantation. It suppresses cytotoxic T-cell activity without producing myelosuppression. Recently, its use has been expanded to include an increasing number of immunologically mediated disorders. Many of these diseases involve the liver and the gastrointestinal tract, which is therefore of interest to practicing gastroenterologists. However, cyclosporine is associated with a number of adverse effects. A knowledge of these side effects and their management is essential for any physician who intends to use this drug. Current gastrointestinal indications and a practical approach to cyclosporine use in gastroenterology are discussed.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 2","pages":"168-75"},"PeriodicalIF":0.0,"publicationDate":"1995-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18646812","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
Access routes for enteral nutrition. 肠内营养的获取途径。
The Gastroenterologist Pub Date : 1995-06-01
J M Marks, J L Ponsky
{"title":"Access routes for enteral nutrition.","authors":"J M Marks,&nbsp;J L Ponsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Comprehensive management of patients includes a thorough evaluation of nutritional requirements. The risks and the benefits of enteral and parenteral supplementations have been heavily investigated. Recent literature supports use of the gastrointestinal tract, when functioning, as the preferred route for supplemental nutrition. There are multiple access routes available to clinicians to provide enteral nutrition, including feeding tubes, which can be placed transnasally, percutaneously, or surgically. These various techniques have individual indications, contraindications, and complications associated with the procedures. They also have varying levels of invasiveness and overall durability. We discuss the different access routes available for enteral feeding, as well as the process for selecting the most appropriate route.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 2","pages":"130-40"},"PeriodicalIF":0.0,"publicationDate":"1995-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18644924","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
Pathophysiology and current concepts in the diagnosis of obstructive jaundice. 梗阻性黄疸的病理生理学及诊断的新概念。
The Gastroenterologist Pub Date : 1995-06-01
W B Lucas, R Chuttani
{"title":"Pathophysiology and current concepts in the diagnosis of obstructive jaundice.","authors":"W B Lucas,&nbsp;R Chuttani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although diagnosing jaundice is quite simple, elucidating the underlying cause can be challenging. Of particular importance is early identification of patients whose jaundice is secondary to extrahepatic obstruction, or what is erroneously referred to as surgical jaundice. Unfortunately, the clinical and biochemical presentation of biliary obstruction is often nonspecific and indistinguishable from other hepatocellular disorders. Over the past decade, there have been numerous technological advances that have radically changed the diagnostic approach to jaundice. Modern gastroenterologists currently have a large armamentarium of imaging and diagnostic procedures from which to choose. We present a review of the pathophysiology, differential diagnosis, and diagnostic evaluation of obstructive jaundice. Special emphasis is placed on reviewing laboratory tests and imaging studies. We provide a simple and rational algorithm for judicious use of new technology in the work-up of obstructive jaundice.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 2","pages":"105-18"},"PeriodicalIF":0.0,"publicationDate":"1995-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18644922","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
Hepatotoxicity: newer aspects of pathogenesis and treatment. 肝毒性:发病机制和治疗的新方面。
The Gastroenterologist Pub Date : 1995-06-01
J Heathcote, I R Wanless
{"title":"Hepatotoxicity: newer aspects of pathogenesis and treatment.","authors":"J Heathcote,&nbsp;I R Wanless","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The etiology and the pathogenesis of different forms of hepatotoxicity are discussed; case reports are included to illustrate the importance of history-taking and examination of liver tissue in establishing a specific diagnosis. The role of alcohol as a hepatotoxin as well as an enzyme-inducing agent is stressed. Genetic factors have been identified that may determine susceptibility to alcoholism and the hepatotoxic effects of alcohol and other compounds. Some cases of drug-induced cholestasis may be explained by disturbances in the known pathways of bile acid uptake, transport, and excretion. The importance of small duct destruction in patients with progressive drug-induced cholestasis is discussed. Finally, the potential hepatic complications of some nonprescription remedies used by adherents of \"alternative medicine\" are described, emphasizing the relevance of thorough etiological inquiry in all patients presenting with hepatic dysfunction.</p>","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"3 2","pages":"119-29"},"PeriodicalIF":0.0,"publicationDate":"1995-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18644923","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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