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pharmacologic treatment of depression in patients with myocardial infarction

Journal of Geriatric Cardiology 2011年第2期8卷 121-126页

作者： Jeong-Hoon Ha Cheuk-Kit Wong Department of Cardiology Dunedin School of Medicine Dunedin Public Hospital University of Otago Dunedin 9001 New Zealand

Depression is a common medical problem and is more prevalent among patients with coronary artery disease. Whether early detection and treatment of depression will enhance cardiovascular outcome is uncertain. Obviously, the safety and efficacy of the anti-depression drugs is an important link. This article reviews the patho-physiologic and behavioural links between depression and cardiovascular disease progression, the treatment of depression, and the potential benefits of anti-depressants in patients with coronary disease.

关键词： depression coronary disease pharmacologic treatment

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Combination strategies for pharmacologic treatment of nonalcoholic steatohepatitis

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World Journal of Gastroenterology 2022年第35期28卷 5129-5140页

作者： Jaspreet Suri Sebastian Borja Joseph K Lim Department of Gastroenterology Norwalk HospitalNorwalkCT 06856United States Department of Internal Medicine Norwalk HospitalNorwalkCT 06850United States Section of Digestive Diseases Yale University School of MedicineNew HavenCT 06520United States

Non-alcoholic steatohepatitis (NASH) is defined as hepatic steatosis, inflammation,and hepatocyte injury with or without fibrosis. It has emerged as thesecond leading indication for liver transplantation with a rising death rate in thenon-transplantable population. While there are many drugs in evaluation,currently no approved therapies are on the market for this condition. Given thisimportance, the Food and Drug Administration has provided formal guidanceregarding drug development for stopping or reversing NASH or NASH associatedfibrosis. The complex pathogenesis of NASH and its bidirectional relationshipwith metabolic syndrome has highlighted multiple drugs of interest thataddress metabolic, inflammatory, and fibrotic factors. A few promising liverspecific targets include farnesoid X receptor agonists and peroxisome proliferatoractivatedreceptor agonists. Previously studied drug classes such as glucagon-likepeptide-1 analogs or sodium/glucose transport protein 2 inhibitors have alsodemonstrated ability to improve hepatic steatosis. Here we discuss currentrationale, scientific work, and preliminary data in combining multiple drugs forthe purposes of a multimodal attack on the pathogenesis of NASH. We highlightmultiple Phase 2 and Phase 3 studies that demonstrate the potential to achieve aresponse rate higher than previously assessed monotherapies for this ***, one of these combination strategies may rise above in its safety andefficacy to become a part of a standardized approach to NASH.

关键词： Non-alcoholic steatohepatitis Fatty liver Combination treatment Drug therapy pharmacologic treatment Clinical trials

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Non-alcoholic fatty liver disease: What has changed in the treatment since the beginning?

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World Journal of Gastroenterology 2014年第39期20卷 14219-14229页

作者： Bülent Baran Filiz Akyüz Division of Gastroenterohepatology Department of Internal Medicine Istanbul University Istanbul Faculty of Medicine Capa 34093 Istanbul Turkey

Non-alcoholic fatty liver disease(NAFLD) is an umbrella term to describe the entire spectrum of this common liver disease. In patients with NAFLD, especially those with non-alcoholic steatohepatitis(NASH), most often have one or more components of the metabolic syndrome, but this is not universal. Although most patients with NAFLD share many clinical features, only a subset of patients develops significant liver inflammation and progressive fibrosis. On the other hand, not all patients with NASH exhibit insulin resistance. NASH can be seen in patients who are lean and have no identifiable risk factors. Many clinical studies have tried numerous drugs and alternative medicine, however, investigators have failed to identify a safe and effective therapy for patients with NASH. As summarized, the heterogeneity of pathogenic pathways in individual patients with NASH may warrant the development of an individualized treatment according to the underlying pathogenic pathway. The differentiation of pathogenetic targets may require the development of diagnostic and prognostic biomarkers, and the identification of genetic susceptibilities. At present, evidence-based medicine provides only a few options including life-style modifications targeting weight loss, pioglitazone and vitamin E in non-diabetic patients with biopsy-proven NASH.

关键词： Non-alcoholic steatohepatitis Pathogenesis Inflammation Fibrosis Life-style changes pharmacologic treatment

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Postoperative ileus: Impact of pharmacological treatment,laparoscopic surgery and enhanced recovery pathways

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World Journal of Gastroenterology 2010年第17期16卷 2067-2074页

作者： Knut Magne Augestad Conor P Delaney Division of Colorectal Surgery University Hospitals Case Medical CenterClevelandOH 44106-5047United States Department of Digestive Surgery Telemedicine and Integrated CareUniversity Hospital North Norway9037 TromsφNorway

Almost all patients develop postoperative ileus (POI) after abdominal *** represents the single largest factor influencing length of stay (LOS) after bowel resection,and has great implications for patients and resource utilization in health *** methods to treat and decrease the length of POI are therefore of great *** the past decade,a substantial amount of research has been performed evaluating POI,and great progress has been made in our understanding and treatment of *** procedures,enhanced recovery pathways and pharmacologic treatment have been *** factor has substantially contributed to decreasing the length of POI and thus LOS after bowel *** editorial outlines resource utilization of POI,normal physiology of gut motility and pathogenesis of *** treatment,fast track protocols and laparoscopic surgery can each have significant impact on pathways causing *** optimal integration of these treatment options continues to be assessed in prospective studies.

关键词： Postoperative ileus Pathophysiology Cost utilization pharmacologic treatment Laparoscopic surgery Enhanced recovery pathways

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