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Anemia and digestive diseases: An update for the clinician

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World Journal of Gastroenterology 2009年第37期15卷 4615-4616页

作者： fernando gomollón Javier P Gisbert Digestive Diseases Service Clinical University Hospital CIBEREHD IACS Avenida San Juan Bosco 15 Zaragoza 50009 Spain Digestive Diseases Service University Hospital "La Princesa" CIBEREHD C/ Diego León 62 Madrid 28006 Spain

Anemia and iron deficiency are so common in digestive diseases that often are underestimated and undertreated. Our goal is to review from classif ication to treatment of the diverse types of anemias in different digestive diseases to update our knowledge on diagnosis and treatment. With the goal of improving the prognosis and quality of life of digestive diseases patients, we will review current transfusion, intravenous iron, and erythropoietin roles in the treatment of anemia.

关键词：消化道疾病贫血临床医生消化系统疾病红细胞生成素生活质量静脉注射治疗

Common misconceptions about 5-aminosalicylates and thiopurines in inflammatory bowel disease

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World Journal of Gastroenterology 2011年第30期17卷 3467-3478页

作者： Javier P Gisbert María Chaparro fernando gomollón Gastroenterology Unit Hospital Universitario de La PrincesaInstituto de Investigación SanitariaPrincesa(IP)and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas28006 MadridSpain Gastroenterology Unit Hospital Clínico Universitario and Centro de Investigación Biomédica en Redde Enfermedades Hepáticasy DigestivasIACS50009 ZaragozaSpain

Misconceptions are common in the care of patients with inflammatory bowel disease(IBD).In this paper,we state the most commonly found misconceptions in clinical practice and deal with the use of 5-aminosalicylates and thiopurines,to review the related scientificevidence,and make appropriate *** of errors needs knowledge to avoid making such errors through ***,the amount of knowledge is increasing so quickly that one new danger is an overabundance of *** is a model of a very complex disease and our goal with this review is to summarize the key evidence for the most common daily clinical *** regard to the use of 5-aminosalicylates,the best practice may to be consider abandoning the use of these drugs in patients withsmall bowel Crohn's *** combined approach with oral plus topical 5-aminosalicylates should be the first-line therapy in patients with active ulcerative colitis;once-daily treatment should be offered as a first choice regimen due to its better compliance and higher *** regard to thiopurines,they seem to be as effective in ulcerative colitis as in Crohn's *** of thiopurines is a form of *** should probably be continued indefinitely because their withdrawal is associated with a high risk of *** is a safe alternative in patients with digestive intolerance or hepatotoxicity due to ***,thiopurine methyltransferase(TPMT)screening cannot substitute for regular monitoring because the majority of cases of myelotoxicity are not TPMT-related.

关键词：氨基水杨酸小肠炎症鸡传染性法氏囊病溃疡性结肠炎硫唑嘌呤临床实践科学证据

Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

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World Journal of Gastroenterology 2009年第37期15卷 4686-4694页

作者： José Antonio García-Erce fernando gomollón Manuel Muoz Transfusion Medicine and Apheresis Unit Haematology and Haemotherapy Regional Service "Miguel Servet" University Hospital Zaragoza 50009 Spain Gastroenterology Unit University Clinical Hospital and Biomedical Investigation Center at Digestive and Hepatic Disease Network c/San Juan Bosco 15 Zaragoza 50009 Spain Transfusion Medicine School of Medicine University of Málaga Málaga 29071 Spain

Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion), which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a f ixed protocol [mostly two by two packed red blood cell (PRC) units] independently of the patient' s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a "one-by-one" administration schedule. Evidencebased clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD) consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within wellconstructed protocols will offer better prospe

关键词：肠疾病临床煽动性 ABT

Use of agents stimulating erythropoiesis in digestive diseases

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World Journal of Gastroenterology 2009年第37期15卷 4675-4685页

作者： Rosario Moreno López Beatriz Sicilia Aladrén fernando gomollón García Department of nephrology San Juan de Dios Hospital Paseo Colón 14 50006 Zaragoza Spain Department of Medicine Universidad de Zaragoza 50009 Zaragoza Spain Department of Medicine (Gastroenterology) Alcaiz Hospital 44600 Alcaiz (Teruel) Spain Department of Gastroenterology Clinical University Hospital "Lozano Blesa" Department of Medicine University of Zaragoza IACS CIBEREHD 50009 Zaragoza Spain

Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron def iciency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as f irst choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). new formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same eff icacy and safety.

关键词：人红细胞生成素消化系统疾病慢性肾功能衰竭传染性法氏囊病红细胞生成素受体综合治疗类风湿关节炎丙型肝炎病毒

Are we giving azathioprine too much time?

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World Journal of Gastroenterology 2008年第36期14卷 5519-5522页

作者： fernando gomollón Santiago García López Department of Digestive Diseases Clinic University Hospital "Lozano Blesa" CIBEREHD IACS Zaragoza Spain Department of Digestive Diseases University Hospital "Miguel Servet" Zaragoza Spain

Azathioprine is currently the key drug in the maintenance treatment of inflammatory bowel diseases. However, there are still some practical issues to be resolved: one is how long we must maintain the drug. Given that inflammatory bowel diseases are to date chronic, non-curable conditions, treatment should be indefinite and only the loss of efficacy or the appearance of serious side effects may cause withdrawal. As regards to efficacy and their maintenance over time, evidence supports the continuous usefulness of the drug in the long term: in fact its withdrawal very substantially increases the risk of relapse. About side effects, azathioprine is a relatively well tolerated drug and even indefinite use seems safe. The main theoretical risks of prolonged use would be the myelotoxicity, hepatotoxicity, and the development of cancer. In fact, serious bone marrow suppression or serious liver damage are uncommon, and can be minimized with proper use of the drug. Recent metanalysis suggests that the risk of lymphoma is real, but the individual risk is rather low, and decision analysis suggests a favorable benefit/risk ratio in the long term. Therefore, in patients with inflammatory bowel diseases in whom azathioprine is effective and well tolerated, the drug should not be stopped. This recommendation concerns the use of azathioprine as a single maintenance drug, and is not necessarily applicable to patients receiving concomitant biological therapy.

关键词：肠炎咪唑硫嘌呤免疫抑制剂药物治疗

Crohnology: A tale of time and times and inflammatory bowel diseases

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World Journal of Gastroenterology 2008年第36期14卷 5489-5490页

作者： fernando gomollón Javier P Gisbert Miquel ngel Gassull Hospital Clínico Universitario Zaragoza Spain Centro de Investigación Biomédica en Enfermedades Hepáticas y Digestivas CIBEREHD IACS Spain Hospital Universitario de la Princesa CIBEREHD Madrid Spain Instituto de Investigación en Ciéncias de la Salud Fundación Germans Trias i Pujol CIBEREHD Badalona Spain

Time, times and timing are key words in inflammatory bowel diseases (IBD). The leifmotif of this issue o World Journal of Gastroenterology is time. We have asked experts to review on the epidemiology of these diseases over time, the changes in innate immunity that could be present in the first time, and then the timing of key treatments. The correct time of using azathioprine, mercaptopurine, infliximab, cyclosporine and surgery are reviewed. We have chosen experts with not only great clinical expertise but also persona interest in clinical and basic investigation. Our goa in this monograph is to get an idea not only of the present but of the immediate future in some of the key management issues in IBD. To this end, we think tha the authors are the most adequate.

关键词：肠炎流行病学先天免疫治疗

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软骨修复:临床应用实践

中国骨科临床与基础研究杂志 2018年第1期 65-65页

作者： Farr J gomoll AH

ISBn-10:3319771515ISBn-13:978-3319771519Springer出版社2018年6月出版2版622页该书由软骨修复领域专家编写,为骨科医师、住院医师、专科医师、运动医学及风湿病学医师提供了宝贵的学习资源。新版基于最新的关节软骨研究证据及理论知识,

关键词：软骨修复

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骨科教程膝关节软骨缺损的手术处理

中华骨科杂志 2011年第3期31卷 I0045-I0064页

作者： A.H. gomoll, MD J. Farr, MD S.D. Gillogly, MD J. Kercher, MD T. Minas, MD, MS 罗浩(译) 郭秦炜(译) 杨渝平(译) 敖英芳(译) 李拉(译) 蒋艳芳(译) A n Instructional Course Lecture American Academy of Orthopaedic Surgeons 北京大学第三医院运动医学研究所 100191

关节软骨缺损在膝关节镜手术中十分常见。如若伴有症状出现，其对膝关节功能的影响堪与晚期骨性关节炎相比。

关键词：膝关节软骨缺损手术处理骨科教程晚期骨性关节炎膝关节功能膝关节镜伴有症状手术中