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Diagnostic delay in inflammatory bowel diseases in a German population

World Journal of Gastroenterology 2024年第29期30卷 3465-3478页

作者： Elisabeth Blüthner Annalena Dehe Carsten Büning Britta Siegmund Matthias Prager Jochen Maul Alexander Krannich Jan Preiß Bertram Wiedenmann Florian Rieder Raneem Khedraki Frank Tacke Andreas Sturm Anja Schirbel Department of Hepatology and Gastroenterology Campus Virchow-Klinikum and Campus CharitéMitteCharité-Universitätsmedizin BerlinBerlin 10117Germany Department of Gastroenterology Vivantes Klinikum im FriedrichshainBerlin 10249Germany Department of Internal Medicine Krankenhaus WaldfriedeBerlin 14163Germany Department of Gastroenterology Infectious Diseases and RheumatologyCharité-Universitätsmedizin BerlinBerlin 12203Germany Praxis für Gastroenterologie Berlin Zehlendorf Berlin 14195Germany Gastroenterologie am Bayrischen Platz Berlin 10825Germany clinical Trial Office Charité-Universitätsmedizin BerlinBerlin 10117Germany Department of Gastroenterology Diabetology and HepatologyVivantes Klinikum NeuköllnBerlin 10117Germany Department of Gastroenterology Hepatology and NutritionDigestive Diseases and Surgery InstituteThe Cleveland Clinic FoundationClevelandOH 44195United States Department of Internal Medicine DRK Kliniken Berlin WestendBerlin 14050Germany Gastroenterologie im Havelland Straße der EinheitFalkensee 14612Germany

BACKGROUND Early diagnosis is key to prevent bowel damage in inflammatory bowel disease(IBD).Risk factor analyses linked with delayed diagnosis in European IBD patients are scarce and no data in German IBD patients *** To identify risk factors leading to prolonged diagnostic time in a German IBD *** Between 2012 and 2022,430 IBD patients from four Berlin hospitals were enrolled in a prospective study and asked to complete a 16-item questionnaire to determine features of the path leading to IBD *** diagnostic time was defined as the time from symptom onset to consulting a physician(patient waiting time)and from first consultation to IBD diagnosis(physician diagnostic time).Univariate and multivariate analyses were performed to identify risk factors for each time *** The total diagnostic time was significantly longer in Crohn’s disease(CD)compared to ulcerative colitis(UC)patients(12.0 vs 4.0 mo;Pime(5.5 vs 1.0 mo;Pime in CD *** UC,fever was correlated(P=0.020)with shorter physician diagnostic time,while fatigue(P=0.011)and positive family history(P=0.046)were correlated with longer physician diagnostic *** We demonstrated that CD patients compared to UC are at risk of long diagnostic *** efforts should focus on shortening the diagnostic delay for a better outcome in these patients.

关键词： Diagnostic time Diagnostic delay Crohn’s disease Ulcerative colitis Germany

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Incorporation of integrative medicine education into undergraduate medical education:a longitudinal study

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Journal of Integrative Medicine 2017年第6期15卷 442-449页

作者： saswati mahapatra anjali bhagra bisrat fekadu zhuo li brent a.bauer dietlind l.wahner-roedler division of general internal medicine mayo clinicRochesterMinnesota 55905USA mayo clinic school of medicine mayo clinic college of medicine and scienceRochesterMinnesota 55905USA biostatistics unit mayo clinicJacksonvilleFlorida 32224USA

OBJECTIVE： Integrative medicine （im） combines complementary medical approaches into conventional medicine and considers the whole person. We implemented a longitudinal im short-course curriculum into our medical school education. This study aimed to evaluate the feasibility and effectiveness of the curriculum via knowledge and attitude surveys regarding im among students. METHODS： A mandatory short im curriculum across all years of medical school was created and taught by im professionals and physician faculty members with expertise in integrative therapies. Graduating classes of 2015 and 2016 completed the same survey in their first and third years of medical school. Paired data analysis was done, and only students who completed surveys at both time points were included in final analyses. RESULTS： Of 52 students in each class, 17 （33%） in the class of 2015 and 22 （42%） in the class of 2016 completed both surveys. After the im curriculum, students＇ knowledge of and comfort with several im therapies--biofeedback, mindfulness, and the use of St. John＇s wort--improved significantly. Students＇ personal health practices also improved, including better sleep, exercise, and stress management for the class of 2015. Students graduating in 2016 reported decreased alcohol use in their third year compared with their first year. CONCLUSION： It is feasible to incorporate im education into undergraduate medical education, and this is associated with improvement in students＇ knowledge of im and personal health practices.

关键词： course curriculum education integrative medicine medical students

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Kyoto classification of gastritis:Advances and future perspectives in endoscopic diagnosis of gastritis

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World Journal of Gastroenterology 2022年第43期28卷 6078-6089页

作者： Osamu Toyoshima Toshihiro Nishizawa Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Medicine and WelfareNarita 286-8520Japan

This editorial provides an update of the recent evidence on the endoscopy-based Kyoto classification of gastritis,clarifying the shortcomings of the Kyoto classification,and providing prospects for future research,with particular focus on the histological subtypes of gastric cancer(GC)and Helicobacter pylori(***)infection *** total Kyoto score is designed to express GC risk on a score ranging from 0 to 8,based on the following five endoscopic findings:Atrophy,intestinal metaplasia(im),enlarged folds(EF),nodularity,and diffuse redness(DR).The total Kyoto score reflects *** status as follows:0,≥2,and≥4 indicate a normal stomach,***-infected gastritis,and gastritis at risk for GC,*** arrangement of collecting venules(RAC)predicts noninfection;EF,nodularity,and DR predict current infection;map-like redness(MLR)predicts past infection;and atrophy and im predict current or past ***,im,and EF all increase the incidence of ***-infected *** is a specific risk factor for ***-eradicated GC,while RAC results in less ***-type GC can be induced by active inflammation,which presents as EF,nodularity,and atrophy on endoscopy,as well as neutrophil and mononuclear cell infiltration on *** contrast,intestinal-type GC develops via atrophy and im,and is consistent between endoscopy and ***,this GC risk-scoring design needs to be improved.

关键词： Kyoto classification Gastritis Endoscopy Gastric cancer Histology Helicobacter pylori

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Physiotherapy in Treating Sexual Pain Disorders in Women: A Systematic Review

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Advances in Sexual Medicine 2016年第3期6卷 26-32页

作者： Mercedes Blanquet Rochera University of Manresa Manresa Spain University of Barcelona Barcelona Spain im clinic Sant Cugat Spain

importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which makes any type of penetration (sexual, tampons, gynaecological examination tools) impossible. In this condition, a woman cannot control these muscle contractions and experiences moderate to intense pain. Objectives: To summarise published evidence on efficacy of physiotherapy for treating female sexual pain disorders, ways to evaluate the condition of a patient and to find the correct treatment. Evidence review: A literature search of Cochrane, PubMed, Journal of Sexual Medicine and Urogynecology Journal databases, SciELO, Google Scholar, Wiley Online Library and University of Barcelona Library was conducted. Findings: Physiotherapy techniques are used to strengthen pelvic floor muscles and relieve pain. Kegel exercises improve the symptoms of sexual pain disorders as they deal with weakened muscles. Vaginal cones exercises are used to strengthen the muscles by means of introduction of gradually increasing weights in the vagina. Biofeedback helps to increase muscle awareness and auto-evaluation of performed exercises. Thermotherapy relaxes muscles and increases elasticity of tissues which helps to reduce pain. Electro-stimulation improves the functionality of muscles. Myofascial therapy consists mainly in manual therapy and in liberating painful trigger points. Conclusions: The role of pelvic physiotherapy is to solve the problems related to sexual pain, recovering the pelvic floor by increasing muscle awareness and proprioception, improving muscle relaxation, toning the muscles and increasing the elasticity of the tissues in order to eliminate or reduce pain. Different exercise techniques, biofeedback, manual therapy and insertion techniques, as well as electro-stimulation and thermotherapy are used to achieve positive results.

关键词： Genito-Pelvic Pain Pelvic Floor Physiotherapy Dyspareunia Sexual Pain Dysfunctions

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Physiotherapy as a Way to Maintain Vaginal Health during Menopause

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Advances in Sexual Medicine 2017年第2期7卷 97-104页

作者： Mercedes Blanquet Rochera Cristina Salar Andreu Yolanda Castellano Madrid Karima Bouallalene Enrique Montero Pau im clinic Fisio 7 Rehabilitation Centre University of Manresa Manresa Spain CEU Cardenal Herrera University Valencia Spain Autonomous University of Barcelona Barcelona Spain Fisio 7 Rehabilitation Centre Manresa Spain A Punto clinic Valencia Spain

The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.

关键词： Menopause Vaginal Health Physiotherapy Pelvic Floor

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Potential implications of Helicobacter pylori-related neutrophil-activating protein

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World Journal of Gastroenterology 2012年第5期18卷 489-490页

作者： Jannis Kountouras Christos Zavos Georgia Deretzi Emmanuel Gavalas Dimitrios Chatzopoulos Panagiotis Katsinelos Elena Tsiaousi Stergios Gagalis Stergios A Polyzos Ioannis Venizelos Department of Medicine Second Medical ClinicAristotle University of ThessalonikiIppokration HospitalThessalonikiGreece

Helicobacter pylori (***) virulence factors promote the release of various chemoattractants/inflammatory mediators,including mainly the neutrophilattractant chemokine interleukin-8 and neutrophilactivating protein (NAP),involved in ***-induced gastric ***-administration of Chios mastic gum (CMG),which inhibits *** NAP,with an *** eradication regimen might add clinical benefits against ***-related gastric pathologies,but possibly not CMG as main *** *** NAP and other ***-related cytotoxins [i.e.,vaculating cytotoxin (VacA)] appear to play a major role in generating and maintaining the ***-associated gastric inflammatory response and *** NAP is a promising vaccine candidate against *** infection (***-I),concerns regarding its potential drawbacks,particularly neurogenic ones,due to possible crossmimicry,should be *** cross-mimicry between *** NAP and/or bacterial aquaporin (AQP) and neural tissues may be associated with the anti-AQP-4 antibody-related neural damage in multiple sclerosis (MS)/neuromyelitis optica ***,the sequence homology found between *** VacA and human Na+/K+-ATPase A subunit suggests that antibodies to VacA involve ion channels in abaxonal Schwann cell plasmalemma resulting in demyelination in some patients.A series of factors have been implicated in inducing blood-brain barrier (BBB) disruption,including inflammatory mediators (e.g.,cytokines and chemokines induced by ***-I) and oxidative *** disruption permits access of AQP4-specific antibodies and T lymphocytes to the central nervous system,thereby playing a major role in multiple sclerosis *** studies show a strong association between ***-I and ***-I induces humoral and cellular immune responses that,owing to the sharing of homologous epitopes (molecular mimicry),cross-react with components of nerves,thereby contributing and perpetuating

关键词：中性粒细胞激活蛋白幽门螺旋杆菌水通道蛋白4 幽门螺杆菌细胞毒素序列同源性特异性抗体

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Variant signaling topology at the cancer cell–T-cell interface induced by a two-component T-cell engager

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Cellular & Molecular immunology 2021年第6期18卷 1568-1570页

作者： Dina Kouhestani Maria Geis Saed Alsouri Thomas GPBumm Hermann Einsele Markus Sauer Gernot Stuhler Department of Internal Medicine II Hematology and OncologyUniversity Clinic WürzburgWürzburgGermany Department of Biotechnology and Biophysics University WürzburgWürzburgGermany

Bispecific T-cell-engaging antibodies(BiTEs)convey antigenic information from cancer to the T-lymphocyte-associated CD3 complex,thus redirecting immune effector cells to induce target cell *** antigenic information from transformed tissues is rarely unambiguous,we recently introduced novel T-cell-engaging antibody fragments called hemibodies for the combinatorial,ultraprecise targeting of cancer.1 Here,we report the unprecedented enhancement of the plasticity of immunological synapse(IS)formation and variant signaling topology at the cancer cell–T-cell interface induced by hemibodies compared to that induced by BiTEs.

关键词： cancer interface topology

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Severe chest pain in a pediatric ulcerative colitis patient after 5-aminosalicylic acid therapy

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World Journal of Gastroenterology 2008年第27期14卷 4400-4402页

作者： Orhan Atay Kadakkal Radhakrishnan Janine Arruda Robert Wyllie Department of Pediatric Gastroenterology and Nutrition The Children’s Hospital Cleveland Clinic

Severe reactions to mesalamine products are rarely seen in pediatric patients. We report a case of a 12-year-old boy who had a severe cardiac reaction to a mesalamine product Asacol. Past medical history is significant for ulcerative colitis (UC) diagnosed at 9 years of age. Colo- noscopy one week prior to admission revealed pancoli- tis. He was treated with Asacol 800 mg three times per day and prednisone 20 mg/d. He was subsequently ad- mitted to the hospital for an exacerbation of his UC and started on intravenous solumedrol. He had improvement of his abdominal pain and diarrhea. The patient com- plained of new onset of chest pain upon initiating Asacol therapy. Electrocardiogram (ECG) revealed non-specific ST-T wave changes with T-wave inversion in the lateral leads. Echocardiogram (ECHO) revealed low-normal to mildly depressed left ventricular systolic function. The left main coronary artery and left anterior descending artery were mildly prominent measuring 5 mm and 4.7 mm, respectively. His chest pain completely resolved within 24-36 h of discontinuing Asacol. A repeat echo- cardiogram performed two days later revealed normal left ventricular function with normal coronary arteries (im- mediate improvement of chest pain, as well as improve- ment of echocardiogram and ECG findings after discon- tinuing Asacol suggests that our patient suffered from a rare drug-hypersensitivity reaction to Asacol.

关键词： 5-对氨基水杨酸溃疡性结肠炎心包炎小儿胸痛

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CLONING AND DETERMINING OF BAC GENE AND Bcl-2 ANDCDK4 EXPRESSION ON ASCITES HEPATOMA CELLLINE Hca-F25/25CL-16A3

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Chinese Journal of Cancer Research 1999年第1期11卷 26-28页

作者：左云飞张耀铮张红任双义 Department of clinic Biochemistry Dalian Medical University Dalian China Department of Traditional Chinese Medicine Dalian Medical University Dalian China Department of Surgery Dalian Medical University Dalian China

***96,000cloneswithanaverageDNAinsertsizeof110kb,coveringthehumangenomeapproximately3times.11]Thedivisioncycleofeukar... 详细信息

***96,000cloneswithanaverageDNAinsertsizeof110kb,coveringthehumangenomeapproximately3times.11]Thedivisioncycleofeukar...

关键词： BAC gene hcl-2 CDK4 Hca-F25lCL-16A3.

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Effects of Ginkgo Biloba Special Extract EGb 761^(█) in Very Mild Cognitive impairment(vMCI)

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Neuroscience & Medicine 2011年第1期2卷 48-56页

作者： Brigitte Grass-Kapanke Arija Busmane Andris Lasmanis Robert Hoerr Reiner Kaschel Alexian Hospital Krefeld KrefeldGermany Adoria clinic RigaLatvia Alma clinic RigaLatvia Dr.Willmar Schwabe GmbH&Co.KG Pharmaceuticals KarlsruheGermany University of Osnabrueck OsnabrueckGermany

Objective: To assess effects of EGb 761? on cognition and quality of life in subjects with very mild cognitive impair-ment. Methods: We randomized 300 subjects aged 45 to 65 with cognitive complaints and low functioning (more than one standard deviation below appropriate norm) in at least one cognitive test to double-blind treatment with once daily 240 mg EGb 761? or placebo for 12 weeks. Results: The exploratory intention-to-treat analysis showed significant im-provement (p improved cognitive functioning and aspects of quality of life in sub-jects with very mild cognitive impairment.

关键词： Ginkgo Biloba EGb 761^(█) Mild Cognitive impairment Memory Concentration Randomised Controlled Trial

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