检索结果-南通市图书馆

Emerging space for non-polyethene-glycol bowel preparations in inflammatory bowel disease-related colonoscopy:Veering toward better adherence and palatability

引用

World Journal of Gastroenterology 2023年第46期29卷 6022-6027页

作者： Raffaele Pellegrino Antonietta Gerarda Gravina Department of Precision Medicine Hepatogastroenterology DivisionUniversity of Campania Luigi VanvitelliNaples 80138Italy

Patients with inflammatory bowel diseases(IBDs)require repeated endoscopic evaluations over time by colonoscopy to weigh disease activity but also for different and additional indications(e.g.,evaluation of postoperative recurrence,colorectal cancer surveillance).Colonoscopy,however,requires adequate bowel preparation to be of quality.The latter is achieved as long as the patient takes a certain amount of product to have a number of bowel movements suitable to clean the colon and allow optimal visualization of the mucosa during endoscopy.However,significant guidelines recommend preparations for patients with IBD not excelling in palatability.This recommendation originates from the fact that most of the studies conducted on bowel preparations in patients with IBD have been done with isosmolar preparations based on polyethylene glycol(PEG),for which,therefore,more safety data exist.As a result,the low-volume non-PEG preparations(e.g.,magnesium citrate plus picosulphate,oral sulphate solutions)have been set aside for the whole range of warnings to be heeded because of their hyperosmolarity.New studies,however,are emerging,leaning in overall for a paradigm shift in this matter.Indeed,such non-PEG preparations seem to show a particularly encouraging and engaging safety profile when considering their broad potential for tolerability and patient preference.Indeed,such evidence is insufficient to indicate such preparations in all patients with IBD but may pave the way for those with remission or well-controlled disease.This article summarizes the central studies conducted in IBD settings using non-PEG preparations by discussing their results.

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Bowel preparation Colonoscopy Polyethylene glycol Low-volume

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

May ChatGPT be a tool producing medical information for common inflammatory bowel disease patients’questions?An evidencecontrolled analysis

引用

World Journal of Gastroenterology 2024年第1期30卷 17-33页

作者： Antonietta Gerarda Gravina Raffaele Pellegrino Marina Cipullo Giovanna Palladino Giuseppe Imperio Andrea Ventura Salvatore Auletta Paola Ciamarra Alessandro Federico Division of Hepatogastroenterology Department of Precision MedicineUniversity of Campania Luigi VanvitelliNaples 80138Italy

Artificial intelligence is increasingly entering everyday healthcare.Large language model(LLM)systems such as Chat Generative Pre-trained Transformer(ChatGPT)have become potentially accessible to everyone,including patients with inflammatory bowel diseases(IBD).However,significant ethical issues and pitfalls exist in innovative LLM tools.The hype generated by such systems may lead to unweighted patient trust in these systems.Therefore,it is necessary to understand whether LLMs(trendy ones,such as ChatGPT)can produce plausible medical information(MI)for patients.This review examined ChatGPT’s potential to provide MI regarding questions commonly addressed by patients with IBD to their gastroenterologists.From the review of the outputs provided by ChatGPT,this tool showed some attractive potential while having significant limitations in updating and detailing information and providing inaccurate information in some cases.Further studies and refinement of the ChatGPT,possibly aligning the outputs with the leading medical evidence provided by reliable databases,are needed.

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Chat Generative Pre-trained Transformer Large language model Artificial intelligence

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Inflammatory bowel disease:Efficient remission maintenance is crucial for cost containment

引用

World Journal of Gastrointestinal Pharmacology and Therapeutics 2017年第2期8卷 114-119页

作者： Giovanni C Actis Rinaldo Pellicano the Medical Center Practice Office hepatogastroenterology division Ospedale Gradenigo Unit of Gastroenterology Ospedale Molinette

The inflammatory bowel diseases(IBD) are chronicincurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority of the IBDs, however, are polygenic low-penetrance diseases, running a lifetime waxing-and-waning course. The prevalent trend is towards a slow worsening and steady cost increase. Each and all drugs of the available arsenal exhibit strengths and weaknesses: Mesalamines are chiefly effectively for mildmoderate colitis, and do not work in Crohn's; steroids do not control some 40% of the ulcerative colitis cases, and are not indicated for Crohn's; thiopurines are effective in the maintenance of the IBDs but do not prevent relapses on withdrawal; biologics are still being used empirically(not monitored) causing further increase of their cost over that of hospitalization. Against all these caveats, two simple rules still hold true: Strict adherence maintenance and avoidance of colitogenic drugs. This matter is expanded in this minireview.

关键词： Inflammatory bowel disease Therapy Cost containment Budget Treatment adherence Inflammatory bowel disease managed care

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis

引用

World Journal of Gastroenterology 2024年第7期30卷 685-704页

作者： Marcello Dallio Mario Romeo Paolo Vaia Salvatore Auletta Simone Mammone Marina Cipullo Luigi Sapio Angela Ragone Marco Niosi Silvio Naviglio Alessandro Federico Department of Precision Medicine Hepatogastroenterology DivisionUniversity of Campania Luigi VanvitelliNaples 80138Italy Department of Precision Medicine Clinical Biochemistry DivisionUniversity of Campania Luigi VanvitelliNaples 80138Italy

BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P0.472 and>0.894 as the best

关键词： Liver cirrhosis Red blood cell distribution width Red blood cell distribution width to platelet ratio Translational Medicine Prognostic biomarker

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Inflammatory bowel disease: Traditional knowledge holds the seeds for the future

引用

World Journal of Gastrointestinal Pharmacology and Therapeutics 2015年第2期6卷 10-16页

作者： Giovanni C Actis Rinaldo Pellicano Floriano Rosina hepatogastroenterology division Ospedale Gradenigo 10153 Torino Italy division of Gastroenterology Ospedale Molinette 10126 Torino Italy

Despite the level of sophistication they have reached nowadays, the available tools for treatment of inflammatory bowel disease(IBD) can at best chronicize the disease but not cure it. Chances to make leap forward from this hold-back may include designs to reach personalized treatment strategies taking advantage of modern genome associated studies, and shift resources towards unfolding inciting pathogenetic steps rather than continuing to develop drugs that address down-stream phenomena. We have arbitrarily chosen to scrutinize a few projects that may make their way in 2015 and mark the history of IBD research. The list includes: the role of appendix as a regulating factor in pathogenesis of ulcerative colitis/proctitis; the reappraisal of(auto)immune phenomena in the era of microbiome; projects to treat IBD by stem cell infusion; recognition of the crucial pathogenetic role of gut microbiome, and attempts to modify it to treat enteric diseases, from clostridium difficile infection to IBD.

关键词： Inflammatory bowel disease Microbiome Stem cells Future treatments Curative appendectomy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection

引用

World Journal of Gastroenterology 2010年第18期16卷 2265-2271页

作者： Chao-Hung Hung Jing-Houng Wang Tsung-Hui Hu Chien-Hung Chen Kuo-Chin Chang Yi-Hao Yen YuanHung Kuo Ming-Chao Tsai Chuan-Mo Lee Division of Hepatogastroenterology Department of Internal MedicineChang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of Medicine

AIM:To elucidate the role of insulin resistance(IR) and serum adiponectin level in hepatocellular carcinoma(HCC) associated with chronic hepatitis C.METHODS:Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC.Homeostasis model assessment of IR(HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus(HCV) infection.RESULTS:Among HCC patients,type 2 diabetics(DM) was more prevalent in HCV subjects(35.6%,n = 59) compared to hepatitis B virus(HBV;12.7%,n = 63) or non-HBV,non-HCV cases(7.1%,n = 28).In patients with chronic hepatitis C,HCC subjects had higher blood sugar(P < 0.001),insulin level(P = 0.003) and HOMAIR(P = 0.018) than those with chronic hepatitis and advanced fibrosis.Age,male sex and body mass index were significantly associated with serum adiponectin level,whereas HOMA-IR was not.Based on stepwise logistic regression analysis,age(OR:1.124,P < 0.001),serum insulin level(OR:1.585,P < 0.001),HOMA-IR(OR:0.495,P = 0.001),DM(OR:11.601,P = 0.002) and male sex(OR:3.877,P = 0.016) were independently associated with HCC.This result was similar even if the diabetic subjects were excluded for analysis.CONCLUSION:Insulin resistance measured by HOMAIR,regardless of the presence of diabetes,is significantly associated with HCC development in patients with chronic HCV infection.

关键词： Hepatitis C virus Hepatocellular carcinoma Insulin resistance Diabetes Adiponectin

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Swab culture monitoring of automated endoscope reprocessors after high-level disinfection

引用

World Journal of Gastroenterology 2012年第14期18卷 1660-1663页

作者： Lung-Sheng Lu Yi-Chun Chiu Ming-Tzung Lin Tsung-Hui Hu King-Wah Chiu Division of Hepatogastroenterology Department of Internal MedicineChang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of Medicine

AIM:To conduct a bacterial culture study for monitoring decontamination of automated endoscope reprocessors(AERs) after high-level disinfection(HLD).METHODS:From February 2006 to January 2011,authors conducted randomized consecutive sampling each month for 7 AERs.Authors collected a total of 420 swab cultures,including 300 cultures from 5 gastroscope AERs,and 120 cultures from 2 colonoscope AERs.Swab cultures were obtained from the residual water from the AERs after a full reprocessing cycle.Samples were cultured to test for aerobic bacteria,anaerobic bacteria,and mycobacterium tuberculosis.RESULTS:The positive culture rate of the AERs was 2.0%(6/300) for gastroscope AERs and 0.8%(1/120) for colonoscope AERs.All the positive cultures,including 6 from gastroscope and 1 from colonoscope AERs,showed monofloral colonization.Of the gastroscopeAER samples,50%(3/6) were colonized by aerobic bacterial and 50%(3/6) by fungal contaminations.CONCLUSION:A full reprocessing cycle of an AER with HLD is adequate for disinfection of the machine.Swab culture is a useful method for monitoring AER decontamination after each reprocessing cycle.Fungal contamination of AERs after reprocessing should also be kept in mind.

关键词：监测自动化消毒机再加工内窥镜文化细菌培养棉真菌污染

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Predictors of rebleeding after initial hemostasis with epinephrine injection in high-risk ulcers

引用

World Journal of Gastroenterology 2010年第43期16卷 5490-5495页

作者： Ming-Luen Hu King-Wah Chiu Yi-Chun Chiu Yeh-Pin Chou Tsung-Hui Hu Shue-Shian Chiou Seng-Kee Chuah Division of Hepatogastroenterology Department of Internal Medicine Chang Gung Memorial Hospital-Kaohsiung Medical Center Chang Gung University College of Medicine

AIM: To identify the predictors of rebleeding after initial hemostasis with epinephrine injection (EI) in patients with high-risk ulcers. METHODS: Recent studies have revealed that endoscopic thermocoagulation, or clips alone or combined with EI are superior to EI alone to arrest ulcer bleeding. However, the reality is that EI monotherapy is still common in clinical practice. From October 2006 to April 2008, high-risk ulcer patients in whom hemorrhage was stopped after EI monotherapy were studied using clinical, laboratory and endoscopic variables. The patients were divided into 2 groups: sustained hemostasis and rebleeding. RESULTS: A total of 175 patients (144, sustainedhemostasis; 31, rebleeding) were enrolled. Univariate analysis revealed that older age (≥ 60 years), advanced American Society of Anesthesiology (ASA) status (category Ⅲ , Ⅳ and Ⅴ ), shock, severe anemia (hemoglobin < 80 g/L), EI dose ≥ 12 mL and severe bleeding signs (SBS) including hematemesis or hematochezia were the factors which predicted rebleeding. However, only older age, severe anemia, high EI dose and SBS were independent predictors. Among 31 rebleeding patients, 10 (32.2%) underwent surgical hemostasis, 15 (48.4%) suffered from delayed hemostasis causing major complications and 13 (41.9%) died of these complications. CONCLUSION: Endoscopic EI monotherapy in patients with high-risk ulcers should be avoided. Initial hemostasis with thermocoagulation, clips or additional hemostasis after EI is mandatory for such patients to ensure better hemostatic status and to prevent subsequent rebleeding, surgery, morbidity and mortality.

关键词： Epinephrine injection High-risk ulcers Initial hemostasis Predictors Rebleeding

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Delayed presentation of intrathoracic esophageal perforation after pneumatic dilation for achalasia

引用

World Journal of Gastroenterology 2009年第35期15卷 4461-4463页

作者： Ming-Tzung Lin King-Wah Chiu Yeh-Pin Chou Ming-Chao Tsai Tsung-Hui Hu Chuan-Mo Lee Chi-Sin Changchien Seng-Kee Chuah Division of Hepatogastroenterology Chang Gang Memorial Hospital Kaohsiung 123Ta-Pei RoadNiaosung HsiangKaohsiung Country 833TaiwanChina Chang Gung University College of MedicineKaohsiung 833TaiwanChina

Pneumatic dilation(PD)is considered to be a safe and effective first line therapy for achalasia.The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation.It has been reported that delayed management of perforation for more than 24 h is associated with high mortality.Surgery is the treatment of choice within 24 h,but the management of delayed perforation remains controversial.Hereby,we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia.She completely recovered after intensive medical care.A review of the literature is also discussed.

关键词：穿孔弛缓食管延迟气囊局部放电死亡率治疗

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effect of ginger Effect of ginger on gastric motility and symptoms of functional dyspepsiaon gastric motility and symptoms of functional dyspepsia

引用

World Journal of Gastroenterology 2011年第1期17卷 105-110页

作者： Ming-Luen Hu Christophan K Rayner Keng-Liang Wu Seng-Kee Chuah Wei-Chen Tai Yeh-Pin Chou Yi-Chun Chiu King-Wah Chiu Tsung-Hui Hu Division of Hepatogastroenterology Department of Internal Medicine Chang Gung Memorial Hospital- Kaohsiung Medical Center Chang Gung University College of Medicine Kaohsiung 83301 Taiwan Discipline of Medicine University ofAdelaide Royal Adelaide Hospital Adelaide SA 5000 Australia

AIM:To evaluate the effects of ginger on gastric motility and emptying,abdominal symptoms,and hormones that influence motility in dyspepsia.METHODS:Eleven patients with functional dyspepsia were studied twice in a randomized double-blind manner.After an 8-h fast,the patients ingested three capsules that contained ginger(total 1.2 g) or placebo,followed after 1 h by 500 mL low-nutrient soup.Antral area,fundus area and diameter,and the frequency of antral contractions were measured using ultrasound at frequent intervals,and the gastric half-emptying time was calculated from the change in antral area.Gastrointestinal sensations and appetite were scored using visual analog questionnaires,and blood was taken for measurement of plasma glucagon-like peptide-1(GLP-1),motilin and ghrelin concentrations,at intervals throughout the study.RESULTS:Gastric emptying was more rapid after ginger than placebo [median(range) half-emptying time 12.3(8.5-17.0) min after ginger,16.1(8.3-22.6) min after placebo,P ≤ 0.05].There was a trend for more antral contractions(P = 0.06),but fundus dimensions and gastrointestinal symptoms did not differ,nor did serum concentrations of GLP-1,motilin and ghrelin.CONCLUSION:Ginger stimulated gastric emptying and antral contractions in patients with functional dyspepsia,but had no impact on gastrointestinal symptoms or gut peptides.

关键词：消化不良胃运动生姜症状 ghrelin 排空时间胃肠蠕动血药浓度

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：