ISRN gastroenterology最新文献_第9页

Gastrointestinal stromal tumors: a review of case reports, diagnosis, treatment, and future directions. 胃肠道间质瘤:病例报告，诊断，治疗和未来方向的回顾。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-04-12 DOI: 10.5402/2012/595968

Christopher B Tan, Wanqing Zhi, Ghulamullah Shahzad, Paul Mustacchia

{"title":"Gastrointestinal stromal tumors: a review of case reports, diagnosis, treatment, and future directions.","authors":"Christopher B Tan, Wanqing Zhi, Ghulamullah Shahzad, Paul Mustacchia","doi":"10.5402/2012/595968","DOIUrl":"https://doi.org/10.5402/2012/595968","url":null,"abstract":"Gastrointestinal stromal tumor (GIST) is a nonepithelial, mesenchymal tumor first described by Mazur and Clark in 1983. Since then, its molecular biology has been studied in great detail. Special interest in the role of tyrosine kinase in its regulation has been the target by different drug research. Mutation in c-kit exons 9, 11, 13, 17 and PDGFRA mutation in exons 12, 14, 18 are responsible for activation of gene signaling system resulting in uncontrolled phosphorylation and tissue growth. However, 5 to 15% of GISTs does not harbor these mutations, which raises additional questions in another alternate signaling pathway mutation yet to be discovered. Diagnosis of GISTs relies heavily on KIT/CD117 immunohistochemical staining, which can detect most GISTs except for a few 3% to 5% that harbors PDGFRA mutation. Newer staining against PKC theta and DOG-1 genes showed promising results but are not readily available. Clinical manifestation of GISTs is broad and highly dependent on tumor size. Surgery still remains the first-line treatment for GISTs. The advancement of molecular biology has revolutionized the availability of newer drugs, Imatinib and Sunitinib. Together with its advancement is the occurrence of Imatinib/Sunitinib drug resistance. With this, newer monoclonal antibody drugs are being developed and are undergoing clinical trials to hopefully improve survival in patients with GISTs.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"595968"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/595968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30610347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 74

The Relationship between Renal Dysfunction and Abnormalities of the Immune System in Patients with Decompensated Cirrhosis. 失代偿期肝硬化患者肾功能障碍与免疫系统异常的关系。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-12-26 DOI: 10.5402/2012/123826

Eiji Kakazu, Yasuteru Kondo, Tooru Shimosegawa

引用次数: 4

Inappropriate Use of Gastric Acid Suppression Therapy in Hospitalized Patients with Clostridium difficile-Associated Diarrhea: A Ten-Year Retrospective Analysis. 难辨梭菌相关性腹泻住院患者不恰当使用胃酸抑制疗法:十年回顾性分析

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-05-31 DOI: 10.5402/2012/902320

Sadat Rashid, Dhyan Rajan, Javed Iqbal, Seth Lipka, Robin Jacob, Valeria Zilberman, Mitanshu Shah, Paul Mustacchia

{"title":"Inappropriate Use of Gastric Acid Suppression Therapy in Hospitalized Patients with Clostridium difficile-Associated Diarrhea: A Ten-Year Retrospective Analysis.","authors":"Sadat Rashid, Dhyan Rajan, Javed Iqbal, Seth Lipka, Robin Jacob, Valeria Zilberman, Mitanshu Shah, Paul Mustacchia","doi":"10.5402/2012/902320","DOIUrl":"https://doi.org/10.5402/2012/902320","url":null,"abstract":"Purpose. The incidence of Clostridium difficile-associated diarrhea (CDAD) has steadily increased over the past decade. A multitude of factors for this rise in incidence of CDAD have been postulated, including the increased use of gastric acid suppression therapy (GAST). Despite the presence of practice guidelines for use of GAST, studies have demonstrated widespread inappropriate use of GAST in hospitalized patients. We performed a retrospective analysis of inpatients with CDAD, with special emphasis placed on determining the appropriateness of GAST. Methods. A retrospective analysis was conducted at a multidisciplinary teaching hospital on inpatients with CDAD over a 10-year period. We assessed the use of GAST in the cases of CDAD. Data collection focused on the appropriate administration of GAST as defined by standard practice guidelines. Results. An inappropriate indication for GAST was not apparent in a majority (69.4%) of patients with CDAD. The inappropriate use of GAST was more prevalent in medical (86.1%) than on surgical services (13.9%) (P < 0.001). There were more cases (67.6%) of inappropriate use of GAST in noncritical care than in critical care areas (37.4%) (P < 0.001). Conclusion. Our study found that an inappropriate use of inpatient GAST in patients with CDAD was nearly 70 percent. Reduction of inappropriate use of GAST may be an additional approach to reduce the risk of CDAD and significantly decrease patient morbidity and healthcare costs.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"902320"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/902320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30693183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Utility of Analgesic and Anxiolytic Medication Dose during Colonoscopy in Identifying Patients with Irritable Bowel Syndrome. 结肠镜检查中镇痛和抗焦虑药物剂量在识别肠易激综合征患者中的应用。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-01-04 DOI: 10.5402/2012/969015

Enoch Lule, Erika Iddings, Lochana Manandhar, Bala Grandhi, John Clements

{"title":"Utility of Analgesic and Anxiolytic Medication Dose during Colonoscopy in Identifying Patients with Irritable Bowel Syndrome.","authors":"Enoch Lule, Erika Iddings, Lochana Manandhar, Bala Grandhi, John Clements","doi":"10.5402/2012/969015","DOIUrl":"https://doi.org/10.5402/2012/969015","url":null,"abstract":"Research question. This paper was done to answer the question on whether patients with IBS require higher analgesic or anxiolytic doses during colonoscopy. Setting. Gastroenterology practice in Michigan, USA. Methods. We reviewed the charts of patients following up with a US based gastroenterology practice. We collected data on whether or not they had IBS, and collected data on analgesic and anxiolytic requirement during colonoscopy. Results. 336 patients were included in the trial. 206 did not have IBS while 130 had a previous diagnosis of IBS. 234 were female (67.2%). When comparing patients who have IBS to those without IBS, we identified no statistically significant difference in midazolam dose (5.5 mg versus 5.5 mg), fentanyl dose ( 117 mg versus 112 mg) or meperidine dose (69 mg versus 69 mg). The lack of differences in medication doses used remained when we controlled for sex, prior analgesic use, and prior abdominal surgery. Conclusion. Dose of analgesic or anxiolytic used during colonoscopy cannot be used to identify patients with IBS.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"969015"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/969015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30408655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Screening for Familial Colorectal Cancer Risk amongst Colonoscopy Patients New to an Open-Access Endoscopy Center. 筛查家族性结直肠癌风险的结肠镜检查患者中新的开放通道内窥镜中心。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-03-22 DOI: 10.5402/2012/152980

Sumana Moole, Thomas J McGarrity, Maria J Baker

{"title":"Screening for Familial Colorectal Cancer Risk amongst Colonoscopy Patients New to an Open-Access Endoscopy Center.","authors":"Sumana Moole, Thomas J McGarrity, Maria J Baker","doi":"10.5402/2012/152980","DOIUrl":"https://doi.org/10.5402/2012/152980","url":null,"abstract":"Purpose. We evaluated a questionnaire to aid in the recognition of CRC risk, as well as patient interest in their risk status within an open-access endoscopy center. Methods. A questionnaire was administered to new patients presenting for colonoscopy from May 2007 to February 2008. 287 patients were enrolled. Family history was evaluated using Amsterdam 1, II, and Revised Bethesda criteria. Recognition of risk and referral for counseling was assessed. Patients' interest to be contacted by a genetic counselor was also assessed. Results. 13.2 % (38/287) of patients met Revised Bethesda criteria. Of these, 18 (47.4 %) were previously told about their increased risk for CRC. Only 1 patient who met Revised Bethesda criteria (2.6 %) was previously referred for genetics, whereas none of the 3 patients who met Amsterdam I or II criteria were referred. 23.7 % of high-risk patients did not want to be contacted if found to be at increased risk for cancer. Conclusion. In our open-access endoscopy system, a significant number of high-risk patients remain unidentified and underreferred for genetic counseling due to numerous barriers. Our findings lend support to taking a public health approach to identifying those at risk for Lynch syndrome by implementing universal screening of all CRC specimens.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":" ","pages":"152980"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/152980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40186037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Lowly expressed ribosomal protein s19 in the feces of patients with colorectal cancer. 结直肠癌患者粪便中低表达的核糖体蛋白s19。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-01-09 DOI: 10.5402/2012/394545

Chih-Cheng Chien, Tien-Chien Tu, Chi-Jung Huang, Shung-Haur Yang, Chia-Long Lee

{"title":"Lowly expressed ribosomal protein s19 in the feces of patients with colorectal cancer.","authors":"Chih-Cheng Chien, Tien-Chien Tu, Chi-Jung Huang, Shung-Haur Yang, Chia-Long Lee","doi":"10.5402/2012/394545","DOIUrl":"https://doi.org/10.5402/2012/394545","url":null,"abstract":"Colorectal cancer (CRC) has become one of the most common fatal cancers. CRC tumorigenesis is a complex process involving multiple genetic changes to several sequential mutations or molecular alterations. P53 is one of the most significant genes; its mutations account for more than half of all CRC. Therefore, understanding the cellular genes that are directly or indirectly related to p53 is particularly crucial for investigating CRC tumorigenesis. In this study, a p53-related ribosomal protein, ribosomal protein S19 (RPS19), obtained from the feces of CRC patients is evaluated by using specifically quantitative real-time PCR and knocked down in the colonic cell line by gene silencing. This study found that CRC patients with higher expressions of RPS19 in their feces had a better prognosis and consistent expressions of RPS19 and BAX in their colonic cells. In conclusion, the potential mechanism of RPS19 in CRC possibly involves cellular apoptosis through the BAX/p53 pathway, and the levels of fecal RPS19 may function as a prognostic predictor for CRC patients.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"394545"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/394545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30408653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Gastric ulceration in diabetes mellitus: protective role of vitamin C. 糖尿病胃溃疡:维生素C的保护作用。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-06-16 DOI: 10.5402/2012/362805

Daniel U Owu, Agona O Obembe, Chukwuemeka R Nwokocha, Ime E Edoho, Eme E Osim

{"title":"Gastric ulceration in diabetes mellitus: protective role of vitamin C.","authors":"Daniel U Owu, Agona O Obembe, Chukwuemeka R Nwokocha, Ime E Edoho, Eme E Osim","doi":"10.5402/2012/362805","DOIUrl":"https://doi.org/10.5402/2012/362805","url":null,"abstract":"The effect of vitamin C administration on gastric acid secretion and ulcer in diabetic rats was studied. Vitamin C (200 mg/kg b.w.) was administered to both streptozotocin-induced diabetic and control groups orally for 28 days. Gastric acid secretion was measured and ulcer was induced using ethanol. Histological changes were observed in the stomach. Basal and stimulated acid secretion in diabetic control rat was significantly (P < 0.01) decreased when compared to vitamin C-treated diabetic group and control. Administration of vitamin C significantly (P < 0.05) increased the histamine-stimulated gastric acid secretion in diabetics than control while reduction in gastric secretion by ranitidine was similar compared with control. Vitamin C treatment significantly (P < 0.05) reduced ulcer index in diabetic group and increased mucus weight when compared with diabetic group which was also confirmed with photomicrographs. The mean body weight of diabetic rats treated with vitamin C was comparable to the control. The blood glucose level was significantly (P < 0.01) reduced in diabetic group given vitamin C (8.9 ± 1.8 mMol/L) compared to the diabetic control (32.2 ± 2.1 g). It is concluded that vitamin C is beneficial in improving gastric acid secretion and protects against ulceration in streptozotocin-induced diabetes mellitus in rats due to its antioxidant potential.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"362805"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/362805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30750050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Trends in early outpatient drug therapy in pediatric inflammatory bowel disease in Finland: a nationwide register-based study in 1999-2009. 芬兰儿童炎症性肠病早期门诊药物治疗趋势:1999-2009年一项基于全国登记的研究

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-08-16 DOI: 10.5402/2012/462642

Lauri J Virta, Kaija-Leena Kolho

{"title":"Trends in early outpatient drug therapy in pediatric inflammatory bowel disease in Finland: a nationwide register-based study in 1999-2009.","authors":"Lauri J Virta, Kaija-Leena Kolho","doi":"10.5402/2012/462642","DOIUrl":"https://doi.org/10.5402/2012/462642","url":null,"abstract":"Objective. There are limited data on the changes of treatment strategies of disease-modifying drugs used to treat pediatric inflammatory bowel disease (IBD). Methods. We utilized data from two national registers: the Drug Reimbursement Register for drug costs (for identifying children with IBD) and the Drug Purchase Register (for exposure to drugs), both of which are maintained by the Social Insurance Institution of Finland. The frequencies and trends of drug therapy strategies during the first year of pediatric IBD were evaluated between 1999 and 2009. Results. A total of 481 children diagnosed with IBD were identified. During the first six months, 68% of the patients purchased systemic corticosteroids; these combined with 5-aminosalicylic acid in almost all cases. The use of corticosteroids was stable from the early years compared with the end of the study period. In Crohn's disease, there was a trend towards more active use of azathioprine: the therapy was introduced earlier and proportion of pediatric patients purchasing azathioprine increased by up to 51% (P < 0.05). Conclusions. In pediatric IBD, the majority of patients purchased corticosteroid within the first six months, reflecting moderate-to-severe disease. During recent years in pediatric Crohn's disease, the therapeutic strategies of oral medication have changed towards more active immunosuppression with azathioprine.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"462642"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/462642","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30887995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

The yearly prevalence of findings in endoscopy of the lower part of the gastrointestinal tract. 每年在胃肠道下半部的内镜检查中发现的患病率。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-12-27 DOI: 10.5402/2012/527634

R J L F Loffeld, B Liberov, P E P Dekkers

{"title":"The yearly prevalence of findings in endoscopy of the lower part of the gastrointestinal tract.","authors":"R J L F Loffeld, B Liberov, P E P Dekkers","doi":"10.5402/2012/527634","DOIUrl":"https://doi.org/10.5402/2012/527634","url":null,"abstract":"Introduction. Endoscopy of the colon and rectum is increasingly used. Aim of the Study. All consecutive endoscopies of the colon and rectum were studied in order to assess the yearly prevalence of significant endoscopic diagnoses. Methods. All consecutive endoscopies of the colon and rectum were included. Endoscopies were done with endoscopes of Olympus. Significant endoscopic diagnoses were defined as colorectal cancer, polyps, diverticuli, large sessile polyps, and inflammatory bowel disease. Results. In 20 years a total of 24431 endoscopies were done. The yearly number of sigmoidoscopies was mean 96, range of 42-370. The number of colonoscopies was mean 1126, range of 643-1912. The number of colonoscopies significantly increased. The number of colonoscopies on request of an internist or gastroenterologist showed a slow but steady increase. Successful caecal intubation rose from 70% to 92% in 2011. Since 1996 there is a steep increase in the percentage of procedures with abnormalities. The number of cancer and polyps increased in twenty years. No great changes were seen in inflammatory bowel disease. Conclusion. Colonoscopy is a procedure with a high diagnostic yield. The number of patients with tumours rose in twenty years.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"527634"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/527634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31167389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Progress in rectal cancer treatment. 直肠癌治疗的进展。

ISRN gastroenterology Pub Date : 2012-01-01 Epub Date: 2012-08-30 DOI: 10.5402/2012/648183

Wim P Ceelen

{"title":"Progress in rectal cancer treatment.","authors":"Wim P Ceelen","doi":"10.5402/2012/648183","DOIUrl":"https://doi.org/10.5402/2012/648183","url":null,"abstract":"The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a \"wait and see\" approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer.","PeriodicalId":89397,"journal":{"name":"ISRN gastroenterology","volume":"2012 ","pages":"648183"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/648183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30899207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9