Italian journal of gastroenterology and hepatology最新文献_第3页

Treatment of rectal cancer--a critical update. 直肠癌的治疗，重大进展。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

N S Williams

引用次数: 0

Use of low dose polyethylene glycol solutions in the treatment of functional constipation. 使用低剂量聚乙二醇溶液治疗功能性便秘。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

D Badiali, E Corazziari

引用次数: 0

Use of polyethylene glycol solution in slow transit constipation. 聚乙二醇溶液在慢传输型便秘中的应用。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

G Bassotti, S Fiorella, P Roselli, R Modesto

引用次数: 0

Virtual colonoscopy--technique and applications. 虚拟结肠镜检查技术与应用。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

H M Fenlon, M A Barish, J T Ferrucci

引用次数: 0

Helicobacters everywhere? Role of Helicobacter spp. in hypertransaminasaemia. 幽门螺杆菌无处不在?幽门螺杆菌在高转氨酶血症中的作用。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

B J Appelmelk, C M Vandenbroucke-Grauls

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Therapy of chronic viral hepatitis: a critical view. 慢性病毒性肝炎的治疗:批判性观点。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

M Rizzetto

{"title":"Therapy of chronic viral hepatitis: a critical view.","authors":"M Rizzetto","doi":"","DOIUrl":"","url":null,"abstract":"Many oral nucleoside analogues that are potent inhibitors of hepatitis B virus have recently been developed for the treatment of hepatitis B. The problems with these drugs are bioavailability, toxicity and the time-dependent emergence of resistant hepatitis B virus mutants. Lamivudine appears to be the most useful in terms of clinical benefit, safety and tolerance. It is active on wild type hepatitis B virus as well as on HBeAg-minus variants of the virus. However, although hepatitis B virus is consistently repressed while on therapy, only a minority of patients are cured or remain in remission after Lamivudine withdrawal. Maintenance therapy would appear to be in order, but the long-term use of Lamivudine is precluded by the emergence of polymerase gene-mutants which may rekindle disease. Combination with other antivirals (Adefovir?) active also against Lamivudine escape mutants opens promising new prospects. There is, as yet, no valid therapy for chronic hepatitis D virus hepatitis. Attempts to improve the results of alpha-interferon therapy in chronic hepatitis C with new interferons, or the manipulation of interferon monotherapy so as to obtain the maximum results compatible with tolerance, have not produced significantly better results than the classic protocols of alpha-interferon monotherapy. A more concrete improvement has been achieved by the combination of interferon with Ribavirin, with the overall rate of response increasing three times compared to interferon monotherapy. Anaemia, however, is a common additional side-effect induced by Ribavirin. Combination therapy has become the treatment of choice for interferon naive patients as well as for interferon relapses; it is not efficacious in patients who have not responded to interferon.","PeriodicalId":79501,"journal":{"name":"Italian journal of gastroenterology and hepatology","volume":"31 8","pages":"781-93"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21582070","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

Meta-analysis as a source of evidence in gastroenterology: a critical approach. 作为胃肠病学证据来源的荟萃分析:一种批判性方法。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

L Pagliaro, G D'Amico, A Puleo

{"title":"Meta-analysis as a source of evidence in gastroenterology: a critical approach.","authors":"L Pagliaro, G D'Amico, A Puleo","doi":"","DOIUrl":"","url":null,"abstract":"Meta-analysis is increasingly used in hepatogastroenterology. Meta-analysis is of value to provide a systematic review of related trials and to display their results in an objective, easily understandable manner. When the trials are sufficiently homogeneous, meta-analysis can document the superiority, (a), or the lack of superiority (b) of a treatment with respect to another (e.g., (a) Interferon plus ribavirin vs Interferon for chronic hepatitis; (b) 5-ASA vs sulfasalazine for maintaining remission in ulcerative colitis). However the interpretation of meta-analysis requires caution. Meta-analysis can be unreliable or unstable if based on a few, small trials (e.g., Tamoxifen vs non-active treatment for hepatocellular carcinoma), or if distorted by confounding variables and publication bias (e.g., glucocorticoids vs standard treatment in alcoholic hepatitis). Eventually, qualitative heterogeneity makes the pooled results of meta-analysis meaningless or questionable (e.g., endoscopic sclerotherapy for prevention of first variceal bleeding in cirrhosis) and should prompt the search for its sources to plan future studies. Finally, meta-analysis of trials measuring the treatment effect of a drug vs a placebo when an active drug is available for comparison provides the limited informative content for the physician of the individual trials (e.g. 5-ASA vs placebo for maintaining remission in ulcerative colitis).","PeriodicalId":79501,"journal":{"name":"Italian journal of gastroenterology and hepatology","volume":"31 8","pages":"723-42"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21581531","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

Cost-effectiveness of gastroscopy. 胃镜检查的成本效益。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

P Bytzer

{"title":"Cost-effectiveness of gastroscopy.","authors":"P Bytzer","doi":"","DOIUrl":"","url":null,"abstract":"In a health economics perspective, no other decision area in gastroenterology has been more debated than the role of gastroscopy in dyspepsia. Cost-effectiveness analyses correlate costs with health outcomes. The cost-effectiveness of a diagnostic strategy must be compared to that of a competing strategy to produce useful information. This review examines the cost-effectiveness of gastroscopy in the management of dyspeptic patients, in particular in relation to the competing strategies of deferred referral guided by the outcome of either empirical antisecretory medication or of a non-invasive Helicobacter pylori test. Estimates of costs of gastroscopy differ widely. Cost estimates are usually much lower in European countries compared to the US. This is probably mainly due to differences in the calculations and in the payer perspective used. Cost-effectiveness analyses in dyspepsia management and the role of gastroscopy are difficult to interpret and impossible to compare due to a lack of uniformity in designing, measuring and reporting costs and health-care related outcome. Compared to empirical acid inhibition and to a test-and-scope strategy initial endoscopy is probably cost-effective--at least in Europe. Based on preliminary findings from clinical trials and from decision analyses a test-and-eradicate management strategy in young dyspeptic patients without warning symptoms seems to be cost-effective compared to early endoscopy. Implementing a test-and-eradicate strategy in primary care will probably save endoscopies without harmful effects. In view of the rapidly changing epidemiology of Helicobacter pylori infection in the Western world the long-term effects of such a policy should be monitored closely.","PeriodicalId":79501,"journal":{"name":"Italian journal of gastroenterology and hepatology","volume":"31 8","pages":"749-60"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21581533","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

Beyond white light endoscopy--the prospect for endoscopic optical biopsy. 超越白光内窥镜——内窥镜光学活检的前景。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

C Fulljames, N Stone, D Bennett, H Barr

{"title":"Beyond white light endoscopy--the prospect for endoscopic optical biopsy.","authors":"C Fulljames, N Stone, D Bennett, H Barr","doi":"","DOIUrl":"","url":null,"abstract":"The most important factor in the successful treatment of cancer is early detection. This will be more likely to facilitate eradication of abnormal cells prior to systemic invasion. White light endoscopy has been an essential tool in medical diagnosis for a number of years. Direct endoscopic inspection of gastrointestinal organs has revolutionised diagnostic techniques, improving the targeting of biopsies of macroscopic morphological abnormalities. Recent technological developments are threatening a further revolution enabling the instantaneous and non-invasive diagnosis of microscopic tissue abnormalities in vivo. This is made possible by improving the level of information that can be obtained from the tissue. As well as the two-dimensional surface morphology image, which the traditional endoscope can view, new techniques enable structure at depth, i.e., the third-dimension, to be imaged in high resolution. Other advances enable the detection of biochemical changes in tissue that precede any changes in morphology, thus enabling earlier diagnosis of tissue abnormalities. This review details recent advances that have the greatest potential, for use in partnership with endoscopy, for the diagnosis of malignancy and pre-malignancy.","PeriodicalId":79501,"journal":{"name":"Italian journal of gastroenterology and hepatology","volume":"31 8","pages":"695-704"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21581527","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

Polyethylene glycol as a non-absorbable prokinetic agent in the lower gastrointestinal tract. 聚乙二醇作为一种不可吸收的下胃肠道促动力剂。

Italian journal of gastroenterology and hepatology Pub Date : 1999-11-01

M Tonini

引用次数: 0