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Systematic review: The placebo effect of psychological interventions in the treatment of irritable bowel syndrome

World Journal of Gastroenterology 2017年第12期23卷 2223-2233页

作者： Carla E Flik laura bakker Wijnand Laan Yanda R van Rood André JPM Smout Niek J de Wit Department of General Practice Julius Centre for Health Sciences and Primary CareUniversity Medical Centre Utrecht Department of Psychiatry and Psychology St Antonius Hospital Department of Psychiatry University Medical Centre Department of Gastroenterology and Hepatology Academic Medical Centre

AIM To determine the placebo response rate associated with different types of placebo interventions used in psychological intervention studies for irritable bowel syndrome. METHODS Randomized controlled trials comparing psychological interventions(stress management/relaxation therapy(cognitive) behavioral therapy, short-term psychodynamic therapy, and hypnotherapy) for the treatment of adult patients with irritable bowel syndrome(IBS) diagnosed with the Manning or Rome criteria with an adequate placebo control treatment and reporting data on IBS symptom severity were identified by searching Pub Med, Embase, the Cochrane Library, CINAHL and Psyc INFO databases. Full-text articles that were written in English and published between 1966 and February 2016 in peer-reviewed journals were selected for the present review. Placebo interventions were considered to be adequate if the number of sessions and the amount of time spent with the therapist were the same as in the active treatment. The placebo response rate(PRR) was computed for IBS symptom severity(primary outcome measure) as well as for anxiety, depression and quality of life(secondary outcome measures). RESULTS Six studies, with a total of 555 patients met the inclusion criteria. Four studies used an educational intervention, whereas two studies used a form of supportive therapy as the placebo intervention. The PRR for IBS symptom severity ranged from 25% to 59%, with a pooled mean of 41.4%. The relative PRR for the secondary outcome measures ranged from 0% to 267% for anxiety, 6% to 52% for depression 20% to 125% for quality of life. The PRR associated with pharmacological treatments, treatment with dietary bran and complementary medicine ranged from 37.5% to 47%. Contrary to our expectations, the PRR in studies on psychological interventions was comparable to that in studies on pharmacological, dietary and alternative medical *** The PRR is probably determined to a larger extent by patient-re

关键词： Placebo effect Psychological interventions Irritable bowel syndrome Systematic review

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Clinical outcomes of patients with duodenal adenocarcinoma and intestinal-type papilla of Vater adenocarcinoma

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World Journal of Gastrointestinal Oncology 2020年第3期12卷 347-357页

作者： laura L Meijer Marin Strijker Jacob K de bakker Jurgen GJ Toennaer Barbara M Zonderhuis Hans J van der Vliet Hanneke Wilmink Joanne Verheij Freek Daams Olivier R Busch Nicole CT van Grieken Marc G Besselink Geert Kazemier Department of Surgery Cancer Center AmsterdamAmsterdam UMCVU University AmsterdamAmsterdamNoord-Holland 1081HVThe Netherlands Department of Surgery Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamAmsterdamNoord-Holland 1105AZThe Netherlands Department of Medical Oncology Cancer Center AmsterdamAmsterdam UMCVU University AmsterdamAmsterdamNoord-Holland 1081HVThe Netherlands Department of Medical Oncology Cancer Center AmsterdamAmsterdam UMCUniversity of Amsterdam AmsterdamNoord-Holland 1105AZThe Netherlands Department of Pathology Cancer Center AmsterdamAmsterdam UMCUniversity of Amsterdam AmsterdamNoord-Holland 1105AZThe Netherlands Department of Pathology Cancer Center AmsterdamAmsterdam UMCVU University Amsterdam Noord-Holland 1081HVThe Netherlands

BACKGROUND Duodenal adenocarcinoma(DA)and intestinal-type papilla of Vater adenocarcinoma(it-PVA)are rare malignancies of the gastrointestinal *** therapeutic options are translated nowadays from treatment strategies for patients with colorectal cancer due to histopathological *** To retrospectively investigate the clinical outcome of patients with DA and *** All patients with DA and it-PVA diagnosed between 2000 and 2017 were included at two academic centers in the *** patients with histopathologically-confirmed DA or it-PVA were eligible for *** outcome was compared between DA and it-PVA per disease *** the subgroup of stage IV disease,survival after local treatment of oligometastases was compared with systemic therapy or supportive *** In total,155 patients with DA and it-PVA were *** with it-PVA more often presented with stage I disease,while DA was more often diagnosed at stage IV(P<0.001).Of all patients,79%were treated with curative *** median survival was 39 mo,and no difference in survival was found for patients with DA and it-PVA after stratification for disease ***(23%)of 31 patients with synchronous stage IV disease underwent resection of the primary tumor,combined with local treatment of *** treatment of metastases was associated with an overall survival of 37 mo,compared to 14 and 6 mo for systemic therapy and supportive care,*** Survival of patients with DA and it-PVA is comparable per disease *** results suggest a potential benefit for local treatment strategies in selected patients with oligometastases,although additional prospective studies are needed.

关键词： Duodenal adenocarcinoma Papilla of Vater adenocarcinoma Clinical outcomes Local treatment Metastases Survival

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