EMJ. Gastroenterology最新文献_第9页

Gut Microbiota: Modulate its Complexity to Restore the Balance 肠道菌群:调节其复杂性以恢复平衡

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10310702

Lucy Smithers

{"title":"Gut Microbiota: Modulate its Complexity to Restore the Balance","authors":"Lucy Smithers","doi":"10.33590/emjgastroenterol/10310702","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10310702","url":null,"abstract":"The importance of the gut microbiota to health is becoming more widely appreciated. The range of commensal microorganisms in healthy individuals and in patients with a variety of digestive diseases is under active investigation, and evidence is accumulating to suggest that both the diversity and balance of bacterial species are important for health. Disturbance of the balance of microorganisms – dysbiosis – is associated with obesity and a variety of diseases. Restoring the balance by modulating the microbiota through diet, probiotics, or drugs is now being developed as a potential treatment for digestive diseases. Rifaximin has been shown to increase levels of beneficial bacterial species without perturbing the overall composition of the microbiota in patients with a variety of digestive diseases, making it a ‘eubiotic’ rather than an antibiotic. Rifaximin has demonstrated clinical benefit in the treatment of symptomatic uncomplicated diverticular disease, where changes in the colonic microbiota contribute to the pathogenesis of this disease. Modulating the microbiota is also a promising treatment for some types of irritable bowel syndrome (IBS) that have been linked to an overgrowth of coliform and Aeromonas species in the small intestine. Rifaximin has demonstrated efficacy in relieving symptoms and reducing relapses in diarrhoeal IBS in the TARGET-1, 2, and 3 trials, without reducing microbial diversity or increasing antimicrobial resistance. While many aspects of the balance of gut microbiota in disease are not yet fully understood, the new understanding of rifaximin as a modulator of gut microbiota may open up new treatment options in digestive disease.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80017583","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

Cystic Pancreatic Lesions Beyond the Guidelines: Can we Make an Evidence-Based Decision Whether to Resect or to Observe? 指南之外的囊性胰腺病变:我们可以做出基于证据的决定是切除还是观察?

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10314932

G. Marchegiani, S. Andrianello, G. Malleo, A. Borin, C. Bassi, R. Salvia

引用次数: 0

Perfect or Failed ERCP: What Makes the Difference? 完美或失败的ERCP:有什么区别?

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10311684

J. Spicak, T. Hucl

引用次数: 1

Bridging Paediatric Liver Diseases to Adult Care: What Does the Gastroenterologist Need to Know? 衔接儿科肝病成人护理:胃肠病学家需要知道什么?

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10313546

D. Kelly

{"title":"Bridging Paediatric Liver Diseases to Adult Care: What Does the Gastroenterologist Need to Know?","authors":"D. Kelly","doi":"10.33590/emjgastroenterol/10313546","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10313546","url":null,"abstract":"Advances in medical and surgical therapy mean that significant numbers of children with previously fatal liver disease are surviving into adult life. In particular, 80% of transplant recipients now survive for over 20 years. Gastroenterologists and hepatologists who treat adult patients need to be aware of the clinical management and complications of diseases originating in infancy, such as biliary atresia, progressive familial intrahepatic cholestasis, Alagille syndrome, and metabolic diseases such as hereditary tyrosinemia type 1. They need to be familiar with the long-term consequences of liver transplantation in childhood, e.g. renal failure, recurrent disease, osteoporosis, and post-transplant malignancies, especially post-transplant lymphoproliferative disease, which differs in presentation and evolution from adult transplant recipients. Survivors of childhood illness require a different approach to that for young adults presenting after 18 years of age. Adult physicians need to consider the emotional, social, and sexual health of these young people, and be aware of the high rate of non-adherence, both for clinic appointments and medication, as well as the implications for graft loss, particularly after transition to adult services. Developing adequate transitional care for these young people is based on effective collaboration at the paediatric–adult interface and is a major challenge for paediatric and adult providers alike in the 21st century.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73170465","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

Biologic Therapies: From Complexity to Clinical Practice in a Changing Environment 生物疗法:在变化的环境中从复杂性到临床实践

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10311701

V. Lane

{"title":"Biologic Therapies: From Complexity to Clinical Practice in a Changing Environment","authors":"V. Lane","doi":"10.33590/emjgastroenterol/10311701","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10311701","url":null,"abstract":"This symposium provided an opportunity for global experts to discuss the challenges posed by the introduction of biosimilars. The impact of the manufacturing process on clinical outcomes, maintaining treatment responses over the long term, and issues surrounding patient management in a changing environment were addressed.\u0000\u0000The symposium was opened by Prof Panaccione describing the evolution of inflammatory bowel disease (IBD) treatment in the last 20 years and how biologics have improved outcomes. Prof D’Haens provided an explanation of the complexity surrounding biologic drug development and the hurdles facing drug manufacturers when ensuring high quality and consistently performing products over time. Prof Panaccione discussed the clinical challenges in balancing the transition from induction to maintenance therapy in order to provide a clinically relevant and sustained response to therapy. He also discussed the evidence for long-term outcomes with adalimumab for IBD. Prof Feagan highlighted the issues faced by clinicians treating patients with biologics, including the ability to switch between biologics without loss of efficacy or impact on safety, and the need to consider interchangeability between biologic therapies and the potential risk and impact of immunogenicity.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81239242","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

Achieving Treatment Goals in Inflammatory Bowel Disease: The Role of Gut-Selective Therapy 实现炎症性肠病的治疗目标:肠道选择性治疗的作用

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10311149

Lauri Arnstein

引用次数: 0

An Update on the Treatment of Helicobacter Pylori Infection 幽门螺杆菌感染的治疗进展

EMJ. Gastroenterology Pub Date : 2015-12-15 DOI: 10.33590/emjgastroenterol/10310813

S. Smith

引用次数: 12

Management of Diverticulitis and Prevention of Recurrence 憩室炎的治疗及预防复发

EMJ. Gastroenterology Pub Date : 2015-12-01 DOI: 10.33590/emjgastroenterol/10314782

P. Andreozzi, F. Zito, G. Sarnelli, R. Cuomo

引用次数: 1

The Geographic Variance of Helicobacter Pylori Infection in Europe and its Impact on the Incidence of Gastric Cancer 欧洲幽门螺杆菌感染的地理差异及其对胃癌发病率的影响

EMJ. Gastroenterology Pub Date : 2014-12-03 DOI: 10.33590/emjgastroenterol/10310651

Ayse Nilüfer Özaydın

{"title":"The Geographic Variance of Helicobacter Pylori Infection in Europe and its Impact on the Incidence of Gastric Cancer","authors":"Ayse Nilüfer Özaydın","doi":"10.33590/emjgastroenterol/10310651","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10310651","url":null,"abstract":"The discovery of Helicobacter pylori was hopeful as this agent was included in the list of ‘preventable- infectious carcinogens’, and many non-treatable gastroduodenal disorders with uncertain causes became treatable infectious diseases. Nevertheless, nowadays frequent antibiotic resistance is observed among H. pylori infections, sometimes as high as 95%. H. pylori is a bacteria that existed for a very long time, which was only recognised in the last 30 years. It can cause a variety of symptoms leading to gastroduodenal disorders from chronic inflammation in the gastrointestinal system to non-cardia gastric cancer. It is acquired in the early years of life and infection is commonly lifelong. The accepted primary route of transmission is person-to-person contact because humans are the only known significant reservoir of H. pylori. The target cell of H. pylori is the gastric mucus secreting cell. The prevalence in Europe shows a huge variety with almost all studies showing a decreasing trend. During childhood the highest prevalence was from Turkey (56.6%) and the lowest was from Czech Republic (4.8%). Among adults, the overall prevalence was found to be between 18.3% (Denmark) and 82.5% (Turkey), with substantial country-to-country variations. The prevalence rate differs by socioeconomic lifestyle characteristics and also genomic structure; it is also higher in less developed countries/populations. While the more commonly used test to determine H. pylori infection is serology, immunoglobulin G by enzyme-linked immunosorbent assay, the urea breath test (UBT), and stool antigen testing are non- invasive tests which are also recommended.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88716616","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: 3

Managing Complicated Diverticular Disease in 2014 2014年复杂憩室病的处理

EMJ. Gastroenterology Pub Date : 2014-12-03 DOI: 10.33590/emjgastroenterol/10313663

M. Soltes, D. Popa, A. Fingerhut, C. Dziri

引用次数: 0