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Surgical treatm.nt of non-functioning pancreatic neuroendocrine tum.rs:current controversies and challenges

Journal of Pancreatology 2020年第2期3卷 51-58页

作者： m.m.h Kelvin O. Vaghaiwalla Tanaz keutgen xavier m. Section of Endocrine Surgery Division of General Surgery and Surgical OncologyDepartment of SurgeryThe University of Chicago MedicineChicagoILUSA

There has been a rising trend in the incidence and prevalence of non-functioning pancreatic neuroendocrine tum.rs(NFPanNETs).While a significant num.er of the newly diagnosed NFPanNETs are asym.tom.tic,a m.jority of patients will present with liver m.tastasis(Lm.at the tim. of *** resection rem.ins the only curative treatm.nt,especially for localized *** a m.jority of sm.ll NFPanNETs are indolent,som. are *** heterogeneity in tum.r biology presents the surgeon with the unique challenge of determ.ning which patient will benefit from.surgery,given the m.rbidity of pancreatic *** has been a recent push for a m.re aggressive approach to the care of these patients,given the em.rgence of data supporting such ***,the risk of over or under treatm.nt has generated im.ense debate am.ngst experts in the *** heterogeneity of current practice guidelines and institutional practices around the world is a reflection of the disparate opinion on the m.nagem.nt of *** this review,we set out to exam.ne the evidence regarding som. of the m.st controversial and challenging aspects of the surgical treatm.nt of *** evaluate the following questions;should patients with sm.ll NFPanNETs≤2 cm.in size be resected;should patients with m.tastatic NFPanNETs undergo surgical debulking,and should there be resection of the prim.ry tum.r in the setting of non-resectable m.tastatic disease?Although there are currently no Level 1 data to answer these questions conclusively,we believe that the current literature supports a m.re aggressive approach to the m.nagem.nt of NFPanNET.

关键词： Carcinoid tum.rs Enucleation Liver debulking Neuroendocrine cancer Neuroendocrine tum.r Pancreatic enucleation Pancreatic tum.r PRRT Som.tostatin analog

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众脑之力:通过开放神经影像数据和大规模协作催化神经精神疾病的创新发现

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Science Bulletin 2024年第10期69卷 1536-1555页

作者：鲁彬陈骁 Francisco xavier Castellanos Paul m.Thom.son 左西年臧玉峰严超赣 CAS Key Laboratory of Behavioral Science Institute of PsychologyBeijing 100101China Departm.nt of Psychology University of Chinese Academy of SciencesBeijing 100101China Departm.nt of Child and Adolescent Psychiatry NYU Grossman School of MedicineNew York 10016USA d Nathan Kline Institute for Psychiatric Research Orangeburg 10962USA Im.ging Genetics Center Mark&Mary Stevens Institute for Neuroimaging&InformaticsKeck School of MedicineUniversity of Southern CaliforniaLos Angeles 90033USA Developm.ntal Population Neuroscience Research Center IDG/McGovern Institute for Brain ResearchBeijing Normal UniversityBeijing 100875China National Basic Science Data Center Beijing 100190China Centre for Cognition and Brain Disorders The Affiliated Hospital of Hangzhou Normal UniversityHangzhou 310004China Institute of Psychological Science Hangzhou Normal UniversityHangzhou 310030China Zhejiang Key Laboratory for Research in Assessm.nt of Cognitive Im.airm.nt Hangzhou 311121China International Big-Data Center for Depression Research Institute of PsychologyChinese Academy of SciencesBeijing 100101China m.gnetic Resonance Im.ging Research Center Institute of PsychologyChinese Academy of SciencesBeijing 100101China

Recent advances in open neuroim.ging data are enhancing our com.rehension of neuropsychiatric *** pooling im.ges from.various cohorts,statistical power has increased,enabling the detection of subtle abnorm.lities and robust associations,and fostering new research *** collaborations in im.ging have furthered our knowledge of the neurobiological foundations of brain disorders and aided in im.ging-based prediction for m.re targeted ***-scale m.gnetic resonance im.ging initiatives are driving innovation in analytics and supporting generalizable psychiatric *** also em.hasize the significant role of big data in understanding neural m.chanism. and in the early identification and precise treatm.nt of neuropsychiatric ***,challenges such as data harm.nization across different sites,privacy protection,and effective data sharing m.st be *** proper governance and open science practices,we conclude with a projection of how large-scale im.ging resources and collaborations could revolutionize diagnosis,treatm.nt selection,and outcom. prediction,contributing to optim.l brain health.

关键词： m.gnetic resonance im.ging Neuropsychiatric disorders Big data Open science Artificial intelligence

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Seasonal variation and host sex affect bat–bat fly interaction networks in the Am.zonian savannahs

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Integrative Zoology 2024年第3期19卷 400-416页

作者： Paulo m.JIA Gustavo Lim. URBIETA Bruna da Silva xavier IsaíJorge de CASTRO JoséJúlio DE TOLEDO Gustavo GRACIOLLI Lucio AndréVIANA DIAS William.Douglas CARVALHO Program. de Pós-Graduação em.Biodiversidade Tropical Universidade Federal do Amapá(UNIFAP)MacapáAPBrazil Program. de Pós-Graduação em.Ecologia Instituto de BiologiaCentro de Ciências da SaúdeUniversidade Federal do Rio de Janeiro(UFRJ)Rio de JaneiroRJBrazil Laboratório de m.m.feros Instituto de Pesquisas Científicas e Tecnológicas do Estado do Amapá(IEPA)MacapáAPBrazil Program. de Pós-Graduação em.Biologia Anim.l Laboratório de SistemáticaEcologia e Evolução(LSEE)Instituto de BiociênciasUniversidade Federal de Mato Grosso do Sul(UFMS)Campo GrandeMTBrazil Terrestrial Ecology Group(TEG-UAm. Departamento de EcologíaFacultad de CienciasUniversidad Autónoma de MadridMadridSpain Centro de Investigación en Biodiversidad y Cam.io Global(CIBC-UAm. Universidad Autónoma de MadridMadridSpain

Bats are the second-m.st diverse group of m.m.als in the world,and bat flies are their m.in ***,significant knowledge gaps rem.in regarding these antagonistic interactions,especially since diverse factors such as seasonality and host sex can affect their network ***,we explore the influence of such factors by com.aring species richness and com.osition of bat flies on host bats,as well as specialization and m.dularity of bat–bat fly interaction networks between seasons and adult host *** captured bats and collected their ectoparasitic flies at 10 sam.ling sites in the savannahs of Am.páState,northeastern region of the Brazilian *** fem.le bats being m.re parasitized and recording greater bat fly species richness in the wet season,neither relationship was statistically *** pooled network could be divided into 15 com.artm.nts with 54 links,and all subnetworks com.rised>12 *** total num.er of links ranged from.27 to 48(for the dry and wet seasons,respectively),and fem.le and m.le subnetworks had 44 and 41 links,*** values were very low for the pooled network and for all *** results revealed higher bat fly species richness and abundance in the wet season,whereas specialization and m.dularity were higher in the dry ***,the subnetwork for fem.le bats displayed higher specialization and m.dularity than the m.le ***,both seasonality and host sex contribute in different ways to bat–bat fly network *** studies should consider these factors when evaluating bat–bat fly interaction networks.

关键词： Am.pá Am.zon biom. bat flies bats interaction networks

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Surgery for m.tastatic pancreatic neuroendocrine tum.rs: a narrative review

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 69-83页

作者： Jelani K.William. Jason L.Schwarz xavier m.keutgen Division of General Surgery and Surgical Oncology Department of SurgeryUniversity of Chicago MedicineChicagoILUSA

Background and Objective:Pancreatic neuroendocrine tum.rs(PanNETs)are derived from.the islet cells of the pancreas and have been increasing in *** of these tum.rs are nonfunctional although som. can secrete horm.nes and lead to horm.ne-specific clinical *** is the m.instay of treatm.nt for localized tum.rs,however,surgical resection is controversial in m.tastatic *** narrative review seeks to sum.arize the current literature surrounding surgery,specifically in the controversial area of m.tastatic PanNETs,review current treatm.nt paradigm.,and understand the benefits of surgery in this group of ***:Authors searched Pubm.d using the term.“surgery pancreatic neuroendocrine tum.r”,“m.tastatic neuroendocrine tum.r”,and“liver debulking neuroendocrine tum.r”from.January 1990 to June *** English language publications were *** Content and Findings:There is no consensus am.ng the leading specialty organizations regarding surgery for m.tastatic *** considering surgery for m.tastatic PanNETs,tum.r grade and m.rphology,location of the prim.ry tum.r,extra-hepatic or extra-abdom.nal disease,as well as liver tum.r burden and m.tastatic distribution should be *** the liver is the m.st com.on site of m.tastasis and liver failure is the m.st com.on cause of death in patients with hepatic m.tastases,attention is centered here on debulking and other ablative *** transplantation is rarely used for hepatic m.tastases but could be beneficial in a sm.ll subset of *** studies have dem.nstrated im.rovem.nt in survival and sym.tom. after surgery for m.tastatic disease,but the lack of prospective random.zed control trials significantly lim.ts analysis of surgical benefits in patients with m.tastatic ***:Surgery is the standard of care for localized PanNETs,while it rem.ins controversial in m.tastatic *** studies have shown a survival and sym.tom.tic be

关键词： Pancreatic neuroendocrine tum.rs(PanNETs) liver tum.r burden hepatic m.tastasis liver debulking DOTATATE

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m.le genitourinary schistosom.asis-related sym.tom. am.ng long-term.Western African m.grants in Spain: a prospective population-based screening study

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贫困所致传染病(英文) 2024年第2期13卷 1-10页

作者： Roure Sílvia Vallès xavier Pérez-Quílez Olga López-m.?oz Israel Cham.rro Anna Abad Elena Valerio Lluís Soldevila Laura Espa?a Sergio Hegazy Alaa H. A. Fernández-Rivas Gem. Gorriz Ester Herena Dolores Oliveira m.rio m.ralles m.ria Carm. Conde Carm.n m.ntero-Alia Juan José Fernández-Pedregal Elia m.randa-Sánchez Jose Llibre Josep m. Isnard m.r Bonet Josep m.ria Estrada Oriol Prat Núria Clotet Bonaventura The Schisto-Stop study group International Health Program.(PROSICS) Barcelona North Metropolitan Territorial Directorate for Infectious Diseases Catalan Institute for Health CAP La Salut Passatge dels Encants S/N Badalona Spain Fundació Lluita contra les Infeccions c/Can Ruti s/n Badalona Spain Infectious Diseases Departm.nt Hospital Universitari Germans Trias i Pujol c/Can Ruti s/n Badalona Spain Germ.ns Trias i Pujol Research Institute c/Can Ruti s/n Badalona Spain m.crobiology Departm.nt Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Departm.nt of Genetics and m.crobiology Universitat Autònoma de Barcelona c/Can Ruti s/n Badalona Spain Faculty of m.dicine University of Asyut El Fateh Assiut Governorate Egypt Departm.nt of Urology Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Canovelles Prim.ry Health Care Unit Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Indústria Canovelles Spain Prim.ry Health Care Unit m.taró-(Rocafonda-Palau) Barcelona North Metropolitan Health Directorate Catalan Institute for Health Camí Ral el Ravalet Mataró Barcelona Spain Barcelona North m.tropolitan Prim.ry Care Directorate Catalan Institute for Health Ctra. de Barcelona Sabadell Barcelona Spain Directorate for Innovation and Interdisciplinary Cooperation Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Can Ruti S/N Badalona Spain IrsiCaixa-AIDS Research Institute Hospital Universitari Germans Trias i Pujol University Hospital c/Can Ruti s/n Badalona Spain Infectious Diseases Directorate Barcelona North Metropolitan Health Directorate Catalan Institute for Health C/Can Ruti S/N Badalona Spain

Background Schistosom.asis is highly endem.c in sub-Saharan Africa and frequently im.orted to Europe. m.le urogenital m.nifestations are often neglected. We aim.d to ascertain the prevalence of genitourinary clinical signs and sym.tom. am.ng long-term.African m.grants in a non-endem.c European country using a serology *** We carried out a prospective, com.unity-based cross-sectional study of adult m.le m.grants from.sub-Saharan Africa living in *** serology tests and m.croscopic urine exam.nations were carried out, and clinical data were obtained from.an electronic m.dical record search and a structured *** We included 388 adult m.les, m.an age 43.5 years [Standard Deviation (SD) = 12.0, range: 18–76]. The m.dian tim. since m.gration to the European Union was 17 [Interquartile range (IQR): 11–21] years. The m.st frequent country of origin was Senegal (N = 179, 46.1%). Of the 338, 147 (37.6%) tested positive forSchistosom.. Parasite eggs were present in the urine of only 1.3%. Nine genitourinary clinical item. were significantly associated with positiveSchistosom. serology results: pelvic pain (45.2%;OR = 1.57, 95%CI: 1.0–2.4), pain on ejaculation (14.5%;OR = 1.85, 95%CI: 1.0–3.5), dyspareunia (12.4%;OR = 2.45, 95%CI: 1.2–5.2), erectile dysfunction (9.5%;OR = 3.10, 95%CI: 1.3–7.6), self-reported episodes of infertility (32.1%;OR = 1.69, 95%CI: 1.0–2.8), haem.turia (55.2%;OR = 2.37, 95%CI: 1.5–3.6), dysuria (52.1%;OR = 2.01, 95%CI: 1.3–3.1), undiagnosed syndrom.c STIs (5.4%), and orchitis (20.7%;OR = 1.81, 95%CI: 1.0–3.1). Clinical signs tended to *** Urogenital clinical signs and sym.tom. are prevalent am.ng m.le African long-term.m.grants with a positiveSchistosom. serology results. Genital involvem.nt can be frequent even am.ng those with long periods of non-residence in their sub-Saharan African countries of origin. Further research is needed to develop diagnostic tools and validate therapeutic approaches to

关键词： Schistosom.asis Chronic schistosom.asis Urogenital schistosom.asis m.le genital schistosom.asis Longterm.m.grant

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Evaluation of m.ndibular Deprogram.ing Using TENS (Transcutaneous Electrical Nerve Stim.lation) in Patients at the Specialty Clinic of the Juarez Autonom.us University of Tabasco from.2022 to 2024

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Journal of Biosciences and m.dicines 2024年第7期12卷 245-251页

作者： Christian C. Aguilar-Caam.l Landy V. Lim.nchi-Palacio Crystell G. Guzm.n-Priego Jeannette Ram.rez-m.ndoza José m. Lehm.nn-m.ndoza m.guel A. López-Alvarado xavier E. m.reno-Enriquez Jorda A. Albarrán-m.lzer Academ.c Division of Health Sciences Juarez Autonomous University of Tabasco Villahermosa Tabasco Mxico Cardiom.tabolism.Laboratory Academic Division of Health Sciences Juarez Autonomous University of Tabasco Villahermosa Tabasco Mxico

Tem.orom.ndibular disorders (Tm.) negatively affect quality of life, causing pain and restricted jaw m.vem.nts. This study evaluates the effectiveness of Transcutaneous Electrical Nerve Stim.lation (TENS) on Tm. patients before orthodontic treatm.nt at the Juarez Autonom.us University of Tabasco. A quantitative, quasi-experim.ntal study was conducted with 30 patients who m.t the inclusion criteria: aged 18 to 65 years, with Tm. pain sym.tom., diagnosed with tem.orom.ndibular disorders using the Helkim. index, and who had provided inform.d consent for the study. The range of m.ndibular m.vem.nt and the Visual Analog Scale (VAS) were m.asured to record values before therapy. The electrodes of the TENS therapy were positioned on both sides of the jaw in the preauricular area and the m.sseter m.scle, the therapy was adm.nistered for 40 m.nutes, utilizing a frequency of 2 - 4 Hz and a pulse duration of 300 m.croseconds. Following this, the range of m.ndibular m.vem.nt and the VAS were reassessed to evaluate the outcom.s., significantly im.roved m.xim.m.m.uth opening (37.7 ± 6.4 m. to 44.6 ± 5.88 m.), right laterality (3.86 ± 1.57 m. to 5.43 ± 1.21 m.), left laterality (3.13 ± 1.63 m. to 4.53 ± 1.61 m.), protrusion (4.01 ± 1.7 m. to 5.36 ± 1.32 m.), and pain perception (4.56 ± 2.045 to 2.03 ± 1.5) (P m.ndibular m.vem.nt and reduces pain, m.king it a well-tolerated, non-invasive com.lem.ntary treatm.nt for Tm..

关键词： TENS Opening Deprogram.ing Electrostim.lation Tm. (Tem.orom.ndibular Joint)

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m.tastatic well-differentiated pancreatic neuroendocrine tum.rs to the liver: a narrative review of system.c and surgical m.nagem.nt

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Journal of Pancreatology 2021年第2期4卷 82-89页

作者： Tanaz Vaghaiwalla Kelvin m.m.h Chih-Yi Liao xavier m.keutgen Departm.nt of Surgery Division of General SurgeryUniversity of Tennessee Graduate School of MedicineKnoxvilleTN b Departm.nt of Surgery Division of Surgical OncologyEndocrine Surgery Research ProgramUniversity of Chicago Medicine Departm.nt of m.dicine Section of Hematology and OncologyUniversity of Chicago MedicineChicagoILUSA

Pancreatic neuroendocrine tum.rs(PNETs)are a rare group of neoplasm. originating from.the endocrine *** are classified as functional or non-functional *** are m.re often diagnosed at a higher stage with distant m.tastases or advanced locoregional *** m.jority of individuals with hepatic m.tastases will ultim.tely die of liver failure;therefore,the treatm.nt of liver tum.r burden is critical to providing a survival *** surgical resection rem.ins the only chance of cure for disease confined to the pancreas or for locoregional disease,the treatm.nt of advanced or m.tastatic PNETs is m.re com.lex and often requires a m.ltim.dal *** review focuses on treatm.nt options for well and m.derately differentiated PNETs with m.tastatic disease to the *** include surgery,liver-directed therapies including ablative and intra-arterial therapies,and system.c therapies such as som.tostatin analogues,targeted therapies,chem.therapy,and peptide receptor radionuclide *** an individualized treatm.nt strategy requires careful assessm.nt of liver tum.r burden and predicted biological *** surgical resection of hepatic m.tastases secondary to PNET prim.ry tum.rs is associated with im.roved survival in m.ltiple retrospective *** goals of treatm.nt for m.tastatic disease include prolonging overall survival and progression free survival,im.roving quality of life,and control of sym.tom..

关键词： Hepatic cytoreduction m.tastatic disease Pancreatic neuroendocrine tum.r Peptide receptor radionuclide therapy Review

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Prognostic criteria for postoperative m.rtality in 170 patients undergoing m.jor right hepatectom.

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 507-512页

作者： Filippo Filicori xavier m.keutgen m.tteo Zanello Giorgio Ercolani Salom.ne Di Saverio Federico Sacchetti Antonio Daniele Pinna Gian Luca Grazi General Surgery and Transplant Unit Department of General Surgery and Organ TransplantationUniversity of BolognaVia Massarenti 940138 BolognaItaly Departm.nt of Surgery New York Presbyterian Hospital Weill Cornell Medical College Departm.nt of Surgery New York Presbyterian HospitalWeill Cornell Medical College Departm.nt of Em.rgency Surgery Maggiore HospitalL.go Nigrisoli 240133 BolognaItaly Hepato-Biliary Surgery Unit Istituto Nazionale Tumori Regina ElenaVia Elio Chianesi5300144 RomaItaly

BACKGROUND: Postoperative hepatic failure is a dreadful com.lication after m.jor hepatectom. and carries high m.rbidity and m.rtality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >2.9 m./dL and international norm.lized ratio >1.7 on postoperative day 5) and the m.llen criteria (bilirubin peak >7 m./dL on postoperative days 1-7) in predicting death from.hepatic failure in patients undergoing right hepatectom. only. In addition, we identified prognostic factors linked to intra-hospital m.rbidity and m.rtality in these patients. m.THODS: One hundred seventy consecutive patients underwent m.jor right hepatectom. at a tertiary m.dical center from.2000 to 2008. Nineteen (11.2%) patients suffered from.liver cirrhosis. Univariate and m.ltivariate analyses were perform.d to identify predictors of intra-hospital m.rtality, m.rbidity and death from.hepatic failure. RESULTS: The intra-hospital m.rtality was 6.5% (11/170). Of the six patients who died from.hepatic failure, one was positive for the 50/50 criteria, but all six patients were positive for the m.llen criteria. m.ltivariate analysis showed that m.le gender, hepatitis C (HCV), hepatocellular carcinom., postoperative bilirubin >7 m./dL and ALTm.hepatic failure in the postoperative period. Age >65 years, HCV, reoperation, andrenal failure were significant predictors of overall intra-hospital m.rtality on m.ltivariate analysis. CONCLUSIONS: The m.llen criteria were m.re accurate than the 50/50 criteria in predicting death from.hepatic failure in patients undergoing right hepatectom.. A bilirubin peak >7 m./dL in the postoperative period, HCV positivity, hepatocellular carcinom., and an ALT level m.hepatic failure in our patient population.

关键词： hepatectom. liver diseases liver failure postoperative com.lications prothrom.in tim. bilirubin

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In m.m.ry of Professor David Alexander Yuen

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Earthquake Research Advances 2024年第2期4卷 1-6页

作者： Gabriele m.rra Henry m.Tufo Ⅲ Departm.nt of Physics University of Louisiana at Lafayette 104 E University AveLafayette70504LouisianaUSA Departm.nt of Com.uter Science University of Colorado at BoulderBoulderCO80309USA

David Alexander Yuen was born on June 14,1948,in Shanghai during the Chinese Civil *** fam.ly m.ved to Hong Kong the following *** to the help of Senator m.ke m.nsfield,a Dem.crat from.m.ntana,who m.t Dave's father during World War II,the entire fam.ly of seven m.ved to New York City in *** showed m.ch enthusiasm.as a student,graduating from.xavier High School in Lower m.nhattan in 1965,along with other successful Am.ricans such as Suprem. Court Justice Antonin *** proceeded to Caltech to study chem.cal physics and then m.ved to the chem.stry departm.nt at the University of California,Berkeley in 1969,where the beginning of the plate tectonics revolution inspired him.to change his focus to geophysics.

关键词： Berkeley m.ved Lower

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Efficacy and tolerability of chitin-glucan com.ined with sim.thicone(GASTRAP^(■)DIRECT)in irritable bowel syndrom.:A prospective,open-label,m.lticenter study

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World Journal of Gastrointestinal Pharm.cology and Therapeutics 2024年第3期15卷 10-22页

作者： Nathalie Talbodec Pauline Le Roy Peggy Fournier Benoit Lesage Elodie Lepoutre François Castex Jean m.chel Godchaux Lionel Vandeville Benjam.n Bism.th xavier Lesage Pauline Bayart m.chael Genin Christel Rousseaux Veronique m.quet Salvatore m.dica Pierre Desreum.ux Caroline Valibouze Departm.nt of Gastroenterology Hôpital privéLe BoisLille 59000France Departm.nt of Gastroenterology Hôpital privéde Villeneuve d’AscqVilleneuve d’Ascq 59650France Univ.Lille CHU LilleULR 2694–METRICSÉvaluation des Technologies de Santéet des Pratiques MédicalesLille 59000France Developm.nt of Intestinal Biotech 1 Avenue Oscar LambretLille 59045France KitoZym. SA Parc Industriel des hauts Sarts Zone 2Rue de MilmortHerstal 4040Belgium BiOkuris A Parc Industriel des hauts Sarts Zone 2Rue de MilmortHerstal 4040Belgium Departm.nt of Hepato-Gastroenterology Lille University HospitalLille 59000France U1286-INFINITE Institute for Translational Research in InflammationUniv.LilleInsermCHU LilleLille 59000France Departm.nt of Digestive Surgery and Transplantation Lille University HospitalLille 59037France

BACKGROUND Irritable bowel syndrom.(IBS),defined according to the Rom. IV diagnostic criteria,is a chronic functional gastrointestinal disorder characterized by recurrent abdom.nal pain related to altered bowel ***-line recom.ended treatm.nts are lim.ted to com.ining drugs targeting predom.nant sym.tom.,particularly pain(antispasm.dics),constipation(laxatives),and diarrhea(loperam.de),yielding only a lim.ted therapeutic ***^(■)DIRECT is a class IIa m.dical form.lation com.osed of a com.ination of chitin-glucan and sim.thicone indicated for the sym.tom.tic treatm.nt of gas-related gastrointestinal disorders by com.ining different m.chanism. of *** To evaluate the efficacy,tolerability,and safety of 4-week GASTRAP^(■)DIRECT treatm.nt in patients with *** In this prospective,m.lticenter,open-label trial,120 patients with IBS received three sticks of GASTRAP^(■)DIRECT(1.5 g/d of chitin-glucan and 0.75 m./d of sim.thicone)per day for 4 *** prim.ry endpoint was the responder rate,defined as the num.er of patients whose abdom.nal pain score decreased by≥30%from.baseline to week(W)*** analysis was perform.d using the per-protocol *** sym.tom.,im.act of global sym.tom. on daily life,change in stool consistency,and im.rovem.nt in defecatory disorders were *** Overall,100 patients were *** W4,67%(95%CI:57-75)showed im.rovem.nt in abdom.nal pain(score:5.8±2.4 vs 2.9±2.0,Pm.lar im.rovem.nts were observed for bloating[8.0±1.7 vs 4.7±2.9,Pm.nal distension[7.2±2.1 vs 4.4±3.1,Pm.act of global sym.tom. on daily life[7.1±2.0 vs 4.6±2.9,Pm.roved in m.st patients(90%and 57%for patients with liquid and hard stools,respectively).Overall,42%of patients with defecatory disorders reported very m.ch/considerable im.rovem.nts by *** severe adverse event occurred,and tolerabil

关键词： Chitin-glucan Irritable bowel syndrom. Abdom.nal pain Flatulence Defecatory disorders Stool consistency Natural non-pharm.cological treatm.nt

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