The Gastroenterologist最新文献_第2页

Radiologic management of hepatolithiasis. 肝内结石的放射治疗。

The Gastroenterologist Pub Date : 1998-03-01

G R Wittich, E vanSonnenberg, B W Goodacre

引用次数: 0

Chronic pancreatitis: a historical and clinical sketch of the pancreas and pancreatitis. 慢性胰腺炎:胰腺和胰腺炎的历史和临床概述。

The Gastroenterologist Pub Date : 1998-03-01

C S Pitchumoni

{"title":"Chronic pancreatitis: a historical and clinical sketch of the pancreas and pancreatitis.","authors":"C S Pitchumoni","doi":"","DOIUrl":"","url":null,"abstract":"Chronic pancreatitis (CP), a disease described only in 1946 by Comfort and colleagues is currently a global disease. Chronic alcoholism, albeit is the most frequent etiologic factor for the disease in most of the affluent nations, a form of CP of undetermined etiology, tropical calculous pancreatitis (nutritional pancreatitis, Afro-Asian pancreatitis, or tropical calculous pancreatopathy) has been recognized to be prevalent in many developing nations. Hereditary pancreatitis inherited as an autosomal dominant disease is reported from all parts of the world. A landmark is the recent discovery of a gene that transmits the disease. Nearly 10% of cases of CP are truly \"idiopathic\" with no identifiable cause. Recent studies indicate that the idiopathic variety of CP has two subsets--a juvenile form and a senile or late onset form, with distinct clinical features. It is extremely rare to see CP secondary to hyperlipidemia or hypercalcemia. These etiologic associations appear to be overemphasized. Epidemiological studies indicate that alcoholism is growing in incidence all over the world along with an increase in all alcohol-associated disorders such as cirrhosis of the liver or pancreatitis. A genetic predisposition to alcoholic pancreatitis is suspected based on population studies, but not proven. The influence of cigarette smoking in enhancing alcohol-induced injury to the pancreas underscores the health hazard associated with alcoholism and cigarette smoking--two habits that often coexist in many individuals. The recent finding that all forms of CP are premalignant further emphasizes the need to enforce preventive measures. The hope is that CP is a preventable disease. The despair is that alcoholism is increasing and spreads across geographic and religious boundaries.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"6 1","pages":"24-33"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20453669","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

Role of motility measurements in managing upper gastrointestinal dysfunction. 运动测量在处理上消化道功能障碍中的作用。

The Gastroenterologist Pub Date : 1998-03-01

W J Snape

{"title":"Role of motility measurements in managing upper gastrointestinal dysfunction.","authors":"W J Snape","doi":"","DOIUrl":"","url":null,"abstract":"Nausea, vomiting, and abdominal pain are common symptoms that suggest many diagnoses. The patient's symptoms may be related to an anatomical defect such as a peptic ulcer or a mechanical small bowel obstruction. However, no anatomical abnormality may be identified despite radiological, endoscopic, or laboratory studies. The cause of the patient's symptoms may have significant impact on the patient's quality of life (nonulcer dyspepsia) and life span (intestinal pseudo-obstruction). Abnormal antroduodenal motility may be the underlying cause of the patient's symptoms. Normally, coordinated phasic contractions in the stomach and small intestine maintain digestion and absorption of food. A prolonged set of phasic contractions (phase 3 of the migrating complex) begins in the stomach and propagates down the small intestine to excrete nondigestible foods, bacteria, and dead cells. Any disturbance in the normal motility pattern can lead to maldigestion and symptoms of upper intestinal dysfunction. Objective tests of motility disturbances in the stomach and small intestine include measurement of gastric emptying, intestinal transit, contractions of the stomach and duodenum, and electrogastrography. Abnormal antroduodenal motility may be secondary to an abnormality in the smooth muscle (myopathy) or the nerves in controlling smooth muscle contractions (neuropathy). Antroduodenal motility measurements may help identify a partial small bowel obstruction, the cause of small intestinal overgrowth, and the cause of chronic abdominal visceral pain. Motility studies may suggest useful drugs for correcting the underlying pathophysiology and relieving symptoms.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"6 1","pages":"44-59"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20454801","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

Refeeding syndrome induced by cautious enteral alimentation of a moderately malnourished patient. 中度营养不良患者谨慎肠内营养引起的再喂养综合征。

The Gastroenterologist Pub Date : 1998-03-01

L T Vaszar, J A Culpepper-Morgan, S M Winter

引用次数: 0

Helicobacter pylori and gastric cancer: what to tell our patients and who to treat? 幽门螺杆菌与胃癌:该告诉我们的病人什么?该治疗谁?

The Gastroenterologist Pub Date : 1998-03-01

M H Floch

引用次数: 0

Magnetic resonance cholangiopancreatography: a new technique for evaluating the biliary tract and pancreatic duct. 磁共振胆管造影:一种评估胆道和胰管的新技术。

The Gastroenterologist Pub Date : 1998-03-01

A S Fulcher, M A Turner, A M Zfass

引用次数: 0

Fecal occult blood testing: clinical value and limitations. 粪便隐血检测:临床价值及局限性。

The Gastroenterologist Pub Date : 1998-03-01

J B Simon

{"title":"Fecal occult blood testing: clinical value and limitations.","authors":"J B Simon","doi":"","DOIUrl":"","url":null,"abstract":"Occult blood in the stool can be detected by chemical (guaiac), heme-porphyrin, or immunological methods. Each has advantages and disadvantages, with the guaiac slide test Hemoccult II (SmithKline Diagnostics) remaining the most widely used. Various technical factors affect its clinical performance, most notably whether the slides are rehydrated before processing; hydration increases test sensitivity for colorectal cancer but markedly decreases specificity, resulting in a large number of false-positive reactions that require invasive and expensive colonic workup. Newer immunological tests generally have high sensitivity, but poor specificity remains an important problem. In clinical screening situations, unhydrated Hemoccult has about 50% sensitivity for colorectal cancers and about 98% specificity. Only 5% to 10% of positive reactions prove due to cancer, however, so the large majority of reactive tests are false positives; this is an important weakness of occult blood screening. Slide hydration detects more tumors, but the predictive value of a positive test for cancer drops to only about 2%, which greatly diminishes the appeal of hydration. Sensitivity of occult blood tests for benign colonic polyps is poor, and most polyps found during workup of a positive reaction are actually detected by chance because of high prevalence in the general population. Controlled clinical trials have now documented that periodic occult blood screening produces a relatively small but significant mortality benefit from colorectal cancer--about 15% to 18% for biennial testing with unhydrated Hemoccult. Aggressive annual screening with hydrated Hemoccult may lower mortality by more than 30% but at a very high cost because of poor specificity and very low predictive value. Regular occult blood testing beginning at age 50 has been endorsed by many professional organizations because of the documented mortality benefit, but poor compliance, high costs, and ethical uncertainties seriously temper its justification. Whether to implement widespread occult blood screening remains a difficult societal decision.","PeriodicalId":79381,"journal":{"name":"The Gastroenterologist","volume":"6 1","pages":"66-78"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20454803","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

Esophageal dilation. 食管扩张。

The Gastroenterologist Pub Date : 1998-03-01

T T Nostrant, P S Nandi

引用次数: 0

Dyspepsia: is a logical treatment plan emerging? 消化不良:一个合理的治疗方案出现了吗?

The Gastroenterologist Pub Date : 1997-12-01

M H Floch, C S Wrobleski

引用次数: 0

Advances in the treatment of esophageal carcinoma. 食管癌的治疗进展。

The Gastroenterologist Pub Date : 1997-12-01

T W Rice, D J Adelstein, G Zuccaro, G W Falk, J R Goldblum

引用次数: 0