检索结果-南通市图书馆

Angiotensin Ⅱ receptor blockers and gastrointestinal adverse events of resembling sprue-like enteropathy:a systematic review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2019年第3期7卷 162-167,I0001页

作者： Ayesha Kamal Christopher Fain Angela Park Peiqi Wang Eduardo Gonzalez-Velez daniel A.leffler Susan M.Hutfless Department of Medicine Division of GastroenterologyJohns Hopkins UniversityBaltimoreMDUSA Johns Hopkins Department of Surgery and Surgical SciencesJohns Hopkins UniversityBaltimoreMDUSA Division of Gastroenterology Beth Israel Deaconess Medical CenterBostonMAUSA Department of Epidemiology Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA

Background:Olmesartan,an angiotensin Ⅱ receptor blocker(ARB),is associated with gastrointestinal symptoms resembling sprue-like *** have proposed that enteropathy may be a class effect rather than *** performed a systematic review to identify literature of sprue-like enteropathy for all ***:Case reports,case series and comparative studies of ARBs were searched on PubMed and Embase databases through 21 November 2018 and then ***:A total of 82 case reports and case series as well as 5 comparative studies,including 248 cases,were selected and *** ARBs listed in the case reports were olmesartan(233 users;94.0%),telmisartan(5 users;2.0%),irbesartan(4 users;1.6%),valsartan(3 users;1.2%),losartan(2 users;0.8%)and eprosartan(1 user;0.4%).The periods between ARB initiation and onset of symptoms ranged from 2 weeks to 13 *** results were reported in 218 cases,in which 201 cases(92.2%)were villous atrophy and 131 cases(60.1%)were intraepithelial *** leucocyte antigen(HLA)testing was performed in 147 patients,among whom 105(71.4%)had HLA-DQ2 or HLA-DQ8 *** antibodies were tested in 169 patients,among whom 167(98.8%)showed negative *** exclusion from the diet failed to relieve symptoms of enteropathy in 127(97.7%)of 130 patients with *** remission of symptoms after discontinuation of ARB was reported in 233(97.4%)of the 239 patients with *** cases(2.8%)reported recurrence of symptoms after restarting olmesartan;rechallenge was not reported for the non-olmesartan *** retrospective studies conducted worldwide had inconsistent study designs(*** in periods of study and case definition)and ***:Although enteropathy is rare,clinicians should remain vigilant of this potential adverse event even years after medication initiation.

关键词： angiotensinⅡreceptor blockers olmesartan enteropathy diarrhea

An open-access endoscopy screen correctly and safely identifies patients for conscious sedation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2016年第4期4卷 281-286,I0001页

作者： Darshan Kothari Joseph D.Feuerstein Laureen Moss Julie D’Souza Kerri Montanaro daniel A.leffler Sunil G.Sheth Department of Medicine and Division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Department of Nursing Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA

Background and aims:Open-access scheduling is highly utilized for facilitating generally low-risk *** screening addresses sedation requirements;however,procedural safety may be compromised if screening is *** sought to determine the reliability of our open-access scheduling system for appropriate use of conscious ***:We prospectively and consecutively enrolled outpatient procedures booked at an academic center by open-access using screening after in-office gastroenterology(GI)*** collected the cases inappropriately booked for conscious sedation and compared the characteristics for significant ***:A total of 8063 outpatients were scheduled for procedures with conscious sedation,and 5959 were booked with *** 78 patients(0.97%,78/8063)were identified as subsequently needing anesthesiologist-assisted sedation;44(56.4%,44/78)were booked through open-access,of which chronic opioid(47.7%,21/44)or benzodiazepine use(34.1%,15/44)were the most common reasons for needing anesthesiologist-assisted *** on chronic benzodiazepines required more midazolam than those not on chronic benzodiazepines(P=0.03)of those patients who underwent conscious ***,patients with chronic opioid use required more fentanyl than those without chronic opioid use(P=0.04).Advanced liver disease and alcohol use were common reasons for patients being booked after in-office consultation and were significantly higher than those booked with open-access(both P<0.01).Conclusions:We observed that the majority of patients can be triaged for conscious sedation using a multi-tiered screening ***,few patients(<1.0%)were inappropriately booked for conscious *** most common reasons for considering anesthesiologist-assisted sedation were chronic opioid,benzodiazepine and/or alcohol use and advanced liver *** suggests that these entities could be included in screening proces

关键词： open-access endoscopy sedation screen

Non-responsive celiac disease in children on a gluten free diet

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2021年第13期27卷 1311-1320页

作者： Gopal Veeraraghavan Amelie Therrien Maya Degroote Allison McKeown Paul D Mitchell Jocelyn A Silvester daniel a leffler Alan M Leichtner Ciaran P Kelly Dascha C Weir Division of Gastroenterology Hepatology and NutritionBoston Children's HospitalBostonMA 02115United States The Celiac Center Department of Medicine and Division of GastroenterologyBeth Israel Deaconess Medical CenterBostonMA 02215United States Celiac Research Program Harvard Medical SchoolBostonMA 02115United States Institutional Centers for Clinical and Translational Research Boston Children's HospitalBostonMA 02115United States Gastrointestinal Therapeutics Takeda Pharmaceutical International CoCambridgeMA 02139United States

BACKGROUND Non-responsive celiac disease(NRCD) is defined as the persistence of symptoms in individuals with celiac disease(CeD) despite being on a gluten-free diet(GFD). There is scant literature about NRCD in the pediatric *** To determine the incidence, clinical characteristics and underlying causes of NRCD in *** Retrospective cohort study performed at Boston Children’s Hospital(BCH). Children < 18 years diagnosed with CeD by positive serology and duodenal biopsies compatible with Marsh Ⅲ histology between 2008 and 2012 were identified in the BCH’s Celiac Disease Program database. Medical records were longitudinally reviewed from the time of diagnosis through September 2015. NRCD was defined as persistent symptoms at 6 mo after the initiation of a GFD and causes of NRCD as well as symptom evolution were detailed. The children without symptoms at 6 mo(responders) were compared with the NRCD group. Additionally, presenting signs and symptoms at the time of diagnosis of CeD among the responders and NRCD patients were collected and compared to identify any potential predictors for NRCD at 6 mo of GFD *** Six hundred and sixteen children were included. Ninety-one(15%) met criteria for NRCD. Most were female(77%). Abdominal pain [odds ratio(OR) 1.8 95% confidence interval(CI) 1.1-2.9], constipation(OR 3.1 95%CI 1.9-4.9) and absence of abdominal distension(OR for abdominal distension 0.4 95%CI 0.1-0.98) at diagnosis were associated with NRCD. NRCD was attributed to a wide variety of diagnoses with gluten exposure(30%) and constipation(20%) being the most common causes. Other causes for NRCD included lactose intolerance(9%), gastroesophageal reflux(8%), functional abdominal pain(7%), irritable bowel syndrome(3%), depression/anxiety(3%), eosinophilic esophagitis(2%), food allergy(1%), eating disorder(1%), gastric ulcer with Helicobacter pylori(1%), lymphocytic colitis(1%), aerophagia(1%) and undetermined(13%). 64% of children with NRCD

关键词： Celiac disease Non-responsive celiac disease Children Gluten-free diet Constipation Abdominal pain

Understanding celiac disease monitoring patterns and outcomes after diagnosis:A multinational,retrospective chart review study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2021年第20期27卷 2603-2614页

作者： Knut EA Lundin Ciaran P Kelly David S Sanders Kristina Chen Sheena Kayaniyil Sisi Wang Rajvi J Wani Caitlin Barrett Shakira Yoosuf Ellen S Pettersen Robert Sambrook daniel a leffler K.G.Jebsen Coeliac Disease Research Centre University of OsloOslo 0450Norway Department of Gastroenterology Oslo University Hospital RikshospitaletOslo 0372Norway Celiac Center Beth Israel Deaconess Medical Center Celiac Research Program Harvard Medical SchoolBostonMA 02115United States Royal Hallamshire Hospital University of SheffieldSheffield S102TNUnited Kingdom Takeda Pharmaceuticals International Co. CambridgeMA 02139United States Real World Evidence Strategy and Analytics ICON plc.TorontoON L7N 3G2Canada Real World Evidence Strategy and Analytics ICON plc.VancouverBC V6B 1P1Canada

BACKGROUND Long-term outcomes and monitoring patterns in real-world practice are largely unknown among patients with celiac *** To understand patterns of follow-up and management of patients with celiac disease,and to characterize symptoms and villous atrophy after *** A retrospective chart review study was performed using medical chart data of patients diagnosed with celiac *** gastroenterology referral centers,with substantial expertise in celiac disease,participated in the United Kingdom,United States,and *** and clinical data were collected from medical *** analyses were conducted on patients with biopsyconfirmed celiac disease,diagnosed between 2008 and 2012,with at least one follow-up visit before December 31,*** demographic and clinical characteristics,biopsy/serology tests and results,symptoms,and comorbidities were captured at diagnosis and for each clinic visit occurring within the study period(i.e.,before the study end date of December 31,2017).RESULTS A total of 300 patients were included in this study[72%female;mean age at diagnosis:38.9 years,standard deviation(SD)17.2].Patients were followed-up for a mean of 29.9 mo(SD 22.1)and there were,on average,three follow-up visits per patient during the study *** two-thirds(68.4%)of patients were recorded as having ongoing gastrointestinal symptoms and 11.0%had ongoing symptoms and enteropathy during *** 80%of patients were referred to a dietician at least once during the follow-up ***(50.0%)of the patients underwent at least one follow-up duodenal biopsy and 36.6%had continued villous *** of monitoring varied between *** were conducted more frequently in Norway and patients in the United States had a longer follow-up *** This real-world study demonstrates variable follow-up of patients with celiac disease despite most patients continuing to have abnormal histology

关键词： Celiac disease Outcomes research Endoscopy Real-world General practice Villous atrophy

利用加压液体萃取技术和两种体外生物测定法对金属污染位点的环境危害进行筛选

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

AMBIO－人类环境杂志 2007年第6期36卷 469-475页

作者： daniel Ragnvaldsson Rune Berglind Mats Tysklind Per leffler 张建军瑞典国防研究署于默奥瑞典国防研究署于默奥大学

快速筛选法可提高成本效率、生产量和对污染位点的风险评估质量。本文研究了加压液体萃取技术和两种体外生物检测的组合方法对烟火工业场所46个表层土壤样本进行风险评价。加压液体萃取可以快速生成与两种生物检测相容的土-水提取物。... 详细信息

快速筛选法可提高成本效率、生产量和对污染位点的风险评估质量。本文研究了加压液体萃取技术和两种体外生物检测的组合方法对烟火工业场所46个表层土壤样本进行风险评价。加压液体萃取可以快速生成与两种生物检测相容的土-水提取物。利用毒理学和化学筛选作出的危害评估揭示那些潜在相对高风险金属污染的地带。数据多元分析显示生物检测的显著抑止作用与提取物中金属含量的水平相关,表明某些金属物有较高的潜在毒性。低pH值和高浓度的溶解有机碳与细胞毒素增加相关,表明这些因素影响金属的生物可利用性。细胞毒素与提取物中金属浓度的相关性高于土壤中的,说明对土壤中金属总浓度的检测不能为土壤潜在毒性提供良好指标。

关键词：金属污染萃取技术筛选法生物测定法环境危害液体加压体外

借鉴美国环保署三联体方法采用灵活的工作策略和筛选方法改进棕色地块的土壤调查

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

AMBIO－人类环境杂志 2007年第6期36卷 476-485页

作者： Christian Maurice Bjrn Gustavsson daniel Ragnvaldsson Bjrn Rydvall Rune Berglind Peter Haglund Torbjrn Johnson Per leffler Karin Luthbom Patrik von Heijne 陶书田瑞典Ramboll公司吕勒奥理工大学瑞典国防研究署 Pelagia顾问公司于默奥瑞典国防研究署于默奥大学瑞典Rambll公司

对于被污染的棕色地块(brownfield sites)及其样品的分析研究要花很多的财力,而所得的结果却常常没有很好的说服力。因此在此类研究中就需要改进研究方法来降低成本,同时提高结果的可信度。美国环境保护局所开发的三联体方法是一种能同... 详细信息

对于被污染的棕色地块(brownfield sites)及其样品的分析研究要花很多的财力,而所得的结果却常常没有很好的说服力。因此在此类研究中就需要改进研究方法来降低成本,同时提高结果的可信度。美国环境保护局所开发的三联体方法是一种能同时满足这两方面要求的方法,其核心特征是对不确定性的管理。在本文介绍的调查中,我们采用现场研究来确定一种可能的方法,运用这种方法可以在实践中管理控制不确定性。考虑的一个实例包括在特定的项目目标前提下,调整样本大小来最优化不确定性,以及在分析工作上所作的努力。此外,评价了几种毒性分析方法在筛选污染位点中的潜在效用。报道这些分析结果的同时,我们在这篇文稿中讨论了一些途径,就是怎样借鉴三联体原理将灵活的工作策略和筛选方法引入到瑞典修复棕色地块的方法中。分层次的途径充分利用了现场的和筛选的方法,其被引入到对棕色地块的评估中,集中分析了任务所要求的响应和可接受的不确定性。

关键词：筛选方法三联体美国环保署地块棕色土壤调查借鉴美国环境保护局

受铜、铬和砷污染土壤处理后的稳定及其评估技术

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

AMBIO－人类环境杂志 2007年第6期36卷 412-417页

作者： Christian Maurice Sofia Lidelw BjrnGustavsson Anders Lttstrm daniel Ragnvaldsson Per leffler Lars Lvgren Solomon Tesfalidet Jurate Kumpiene 王丽平瑞典北方土壤修复中心吕勒奥科技大学瑞典于默奥大学瑞典国防研究署默奥市瑞典国防研究署瑞典于默奥大学无机化学专业瑞典于默奥大学化学系吕勒奥科技大学废物科学与技术部

土壤修复主要通过将受污染土壤进行挖掘和填埋,这种方法在进行大量位点修复时不太切合实际,因此要选择其它棕地(brownfield)修复方法。本研究介绍了评估受铜铬砷(CCA)污染土壤采用含铁(Fe)爆破砂(BS)或嵌氧颗粒(OSG)处理后的化学稳定过... 详细信息

土壤修复主要通过将受污染土壤进行挖掘和填埋,这种方法在进行大量位点修复时不太切合实际,因此要选择其它棕地(brownfield)修复方法。本研究介绍了评估受铜铬砷(CCA)污染土壤采用含铁(Fe)爆破砂(BS)或嵌氧颗粒(OSG)处理后的化学稳定过程。就工业尺度下混合改良物的可行性和在不同氧化还原条件下的稳定效率对这种稳定技术进行了评估。在野外自然条件下,采用1m^3测渗计调查了这种稳定性并在实验室(10L)对氧化还原条件的效应进行了评估。结果表明改良物的添加率最低时(0.1%和1%)化学计量中还有足够的铁,但是不管在野外还是实验室都是采用高添加率的改良物(8%和17%)效果较好。铁和混合物的颗粒大小会影响稳定效率。厌氧条件的发展(模拟自水饱和度)会提高砷(As^(3+))的份额,因此增强了砷的迁移能力。在有氧条件下,采用高浓度OSG提高了孔隙水中镍(Ni)和铜(Cu)的浓度,但是在厌氧条件下,与未作处理的土壤相比,砷的淋溶率降低了,而镍和铜的淋溶并不是关键的。所处理土壤的最终目的决定了改良方案,也就是说,对于在厌氧条件下填埋的土壤,OSG浓度为10%较合适。也可以在有氧条件下将1%的BS与土壤混合,置于填埋区上层或者棕色地块(brownfield site)原处。另外从长期来看,采用BS处理似乎比用OSG处理效果要好。

关键词：土壤处理稳定过程砷污染铜铬评估技术氧化还原条件受污染土壤