EMJ. Gastroenterology最新文献_第4页

Making the Invisible Visible: The Hidden Cost of Paediatric Inflammatory Bowel Disease 使隐形可见:儿童炎症性肠病的隐性成本

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10312720

D. Turner

引用次数: 1

Burning Questions in Inflammatory Bowel Disease: Learnings from Emerging Drug Options and Clinical Cases 炎症性肠病亟待解决的问题:从新出现的药物选择和临床病例中学习

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10312117

Megan Breuer

引用次数: 0

Switching off Inflammation with Diet: A Review of Exclusive Enteral Nutrition in Children with Crohn’s Disease 通过饮食消除炎症:对克罗恩病儿童独家肠内营养的综述

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10314458

A. Day

引用次数: 1

Dysphagia and Bone Marrow Failure: A Rare Neoplastic Mimic 吞咽困难和骨髓衰竭:一种罕见的肿瘤模拟

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10310718

P. Kangesu, Luke Bracegirdle, D. Lloyd

{"title":"Dysphagia and Bone Marrow Failure: A Rare Neoplastic Mimic","authors":"P. Kangesu, Luke Bracegirdle, D. Lloyd","doi":"10.33590/emjgastroenterol/10310718","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10310718","url":null,"abstract":"A 54-year-old male with a history of multiple autoimmune arthritides was admitted following a 3-week history of progressive dysphagia with odynophagia to solids and liquids, with significant weight loss, night sweats, and exertional dyspnoea. Oesophagogastroduodenoscopy revealed an obstructing oesophageal stricture. Blood tests showed neutropaenia and high levels of inflammatory markers, suggestive of primary oesophageal malignancy. Oesophageal and bone marrow biopsies demonstrated inflammatory change not suggestive of malignancy. PET showed highly active nodules in the left lung and sigmoid colon, but the oesophagus was clear. Following a clinical rheumatology review, a differential diagnosis of inflammatory lesions, most likely secondary to systemic rheumatoid, was considered. The patient responded well to high-dose intravenous steroid therapy. Subsequent outpatient interval high-resolution CT demonstrated complete resolution of the lung nodule. He was maintained on oral prednisolone and methotrexate, having no further symptoms of dysphagia or neutropenia. A literature search revealed no published reports or case studies outlining a similar history to the reported patient: rheumatoid arthritis presenting to hospital as potential oesophageal malignancy.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89790944","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

Who Audits Who Using Resection Margins: The Surgeon, or the Pathologist? 谁审查谁使用切除边缘:外科医生，还是病理学家?

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10311616

E. Salmo, N. Haboubi

引用次数: 0

A Rare Case of an Inflammatory Myofibroblastic Tumour of the Colon as a Probable Result of Tumour Recurrence after Hemicolectomy 一例罕见的炎症性肌纤维母细胞肿瘤，可能是半结肠切除术后肿瘤复发的结果

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10310266

S. Rauniyar

引用次数: 0

Editor’s Pick: Refractory Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Management 编者精选:难治性胃食管反流病:病理生理学、诊断和管理

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10314735

Z. Nabi, Arun Karyampudi, D. Nageshwar Reddy

{"title":"Editor’s Pick: Refractory Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Management","authors":"Z. Nabi, Arun Karyampudi, D. Nageshwar Reddy","doi":"10.33590/emjgastroenterol/10314735","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10314735","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is one of the most commonly encountered gastrointestinal diseases in clinical practice. Proton pump inhibitors (PPI) remain the cornerstone of the treatment of GERD. Up to one-third of patients do not respond to optimal doses of PPI and fall into the category of refractory GERD. Moreover, the long-term use of PPI is not risk-free, as previously thought. The pathophysiology of refractory GERD is multifactorial and includes reflux related and unrelated factors. It is therefore paramount to address refractory GERD as per the aetiology of the disease for optimal outcomes. The management options for PPI refractory GERD include optimisation of PPI, lifestyle modifications, and the addition of alginates and histamine-2 receptor blockers. Neuromodulators, such as selective serotonin reuptake inhibitors or tricyclic antidepressants, may be beneficial in those with functional heartburn and reflux hypersensitivity. Laparoscopic antireflux surgeries, including Nissen’s fundoplication and magnetic sphincter augmentation, are useful in patients with objective evidence of GERD on pH impedance studies with or without a hiatal hernia. More recently, endoscopic antireflux modalities have emerged as an alternative to surgery in patients with PPI-dependent and PPI-refractory GERD. Long-term data and randomised comparison studies, however, are required before incorporating endoscopic therapies in the management algorithm for refractory GERD.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88772699","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: 1

Practical Management of Anaemia After a Gastrointestinal Bleed 胃肠道出血后贫血的实用处理

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10314025

S. Amisten

{"title":"Practical Management of Anaemia After a Gastrointestinal Bleed","authors":"S. Amisten","doi":"10.33590/emjgastroenterol/10314025","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10314025","url":null,"abstract":"Prof Gralnek presented a clinical case on the management of gastrointestinal bleeding (GIB) as a result of Helicobacter pylori infection, and the role of intravenous (IV) ferric carboxymaltose (FCM) as a treatment option for iron deficiency anaemia (IDA) was discussed. IV iron is suitable for patients who have intolerance or limited or no response to oral iron, haemoglobin (Hb) <10 g/dL, or Hb >10 g/dL with cardiovascular or respiratory comorbidities. Prof Gralnek stressed that IDA is common, often underdiagnosed and undertreated, and that the choice between oral or IV iron therapy depends on the degree of anaemia, presence of inflammation, and adherence to oral iron therapy. The main objective of iron treatment is to normalise Hb and iron parameters, and gastroenterologists need to be more aware of anaemia beyond the acute GIB episodes.\u0000\u0000Prof Lanas presented a clinical case on the management of patients taking anticoagulants (AC) or antithrombotics (AT) who have anaemia due to GIB, and highlighted challenges associated with reducing the risk of bleeds while avoiding thrombotic events. Prof Lanas highlighted clinical dilemmas arising from stopping, restarting, and switching AC in patients with anaemia and GIB, as well as Hb management at discharge. He also stressed that GIB, and especially anaemia or iron storage depletion, are frequently encountered in patients taking AT, and may have a direct impact on mortality, morbidity, and quality of life (QoL). Anaemia and iron deficiency affect mortality, recovery, and QoL in patients who need a rapid restoration of Hb levels and iron stores to decrease the risk of cardiovascular events. Prof Lanas concluded by explaining that FCM therapy has a favourable safety profile, and is more effective, faster, and cost-effective compared to oral iron therapy, and therefore represents a good therapeutic option for anaemic GIB patients with elevated risk of thrombosis.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76581773","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: 1

‘Old but Gold’ – Insights About Anti-TNF-α Therapy in the Treatment of Inflammatory Bowel Disease “老而有金”——抗tnf -α治疗炎症性肠病的见解

EMJ. Gastroenterology Pub Date : 2019-12-05 DOI: 10.33590/emjgastroenterol/10311943

D. Jacobs

引用次数: 0

Defining the Future of Inflammatory Bowel Disease Care: The Pivotal Role of Personalised Treatment 定义炎症性肠病护理的未来:个性化治疗的关键作用

EMJ. Gastroenterology Pub Date : 2019-11-04 DOI: 10.33590/emjgastroenterol/10313504

S. Webster

{"title":"Defining the Future of Inflammatory Bowel Disease Care: The Pivotal Role of Personalised Treatment","authors":"S. Webster","doi":"10.33590/emjgastroenterol/10313504","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10313504","url":null,"abstract":"At the 14th Annual Congress of European Crohn’s and Colitis Organisation (ECCO), a symposium was convened to discuss the present and future of personalised care for patients with inflammatory bowel disease (IBD). IBD is not one disease: the clinical presentation, disease course, and treatment response differ in every patient. As such, personalised care is considered the best approach for effective management. Importantly, it is acknowledged that IBD is not confined to the gut. Although the predominant symptoms manifest in the organ, the inflammation is likely to be systemic. The importance of learning from and collaborating with specialists who treat associated conditions, such as spondyloarthritis (SpA), will become the key to managing IBD at the individual level. IBD is known to be influenced by genetic as well as environmental factors; however, some are yet to be identified. Advances in understanding ‘omes’ (e.g., genome, transcriptome, microbiome, etc.) and how they impact a person’s IBD journey are rapidly occurring. At the congress, experts provided their insights into recent developments in personalised care and how to optimise current tools at their disposal, as well as evolving methodologies that are anticipated to offer increased efficiency in the future, e.g., the introduction of systems biology.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"201 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86737717","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