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Optimization of the treatment with immunosuppressants and biologics in inflammatory bowel disease

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World Journal of Gastroenterology 2014年第29期20卷 9675-9690页

作者： Sara Renna Ambrogio Orlando Division of Internal Medicine ‘‘Villa Sofia-V.Cervello’’ Hospital

Many placebo controlled trials and meta-analyses evaluated the efficacy of different drugs for the treatment of inflammatory bowel disease (IBD), including immunosuppressants and biologics. Their use is indicated in moderate to severe disease in non responders to corticosteroids and in steroid-dependent patients, as induction and maintainance treatment. Infliximab, as well as cyclosporine, is considered a second line therapy in the case of severe ulcerative colitis, or non-responders to intravenous corticosteroids. An adequate dosage and duration of therapy with thiopurines should be reached before evaluating their efficacy. Methotrexate is a valid option in patients with Crohn’s disease but its use is confined to patients who are intolerant or non-responders to thiopurines. Evidence for the use of methotrexate in ulcerative colitis is insufficient. The use of thalidomide and mycophenolate mofetil is not recommended in patients with inflammatory bowel disease, these treatments could be considered in case of failure of all other therapeutic options. In patients with moderately active ulcerative colitis, refractory to thiopurines, the use of tacrolimus is considered an alternative to biologics. An increase of the dose or a decrease in the interval of administration of biological treatment could be useful in the presence of an incomplete clinical response. In the case of primary failure of an anti-tumor necrosis factor alpha a switch to another one should be considered. Data on the efficacy of combination therapy are up to now insufficient to consider this strategy in all IBD patients. The final outcome of the treatment should be considered the clinical remission, with mucosa healing, and not the clinical response. The evaluation of serum concentration of thiopurine methyl transferase activity, thiopurine metabolites, biologic serum levels and antibiologic antibodies could be useful for the management of the treatment but it has not been routinely applied in cl

关键词： Inflammatory bowel disease Optimization Immosuppressants Biologics Crohn's disease Ulcerative colitis

Methodology for high-quality studies on course and prognosis of inflammatory bowel disease

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World Journal of Gastroenterology 2012年第29期18卷 3800-3805页

作者： Irene Modesto Giovanni Perricone Ambrogio Orlando Mario Cottone Division of Internal Medicine "Villa SofiaCervello" HospitalUniversity of Palermo790146 PalermoItaly

Inflammatory bowel diseases(IBDs) are characterized by a chronic course with an alternation of relapses and *** about prognosis are important for the patient who wants to know how the disease will affect his/her life and also for clinicians to make management *** selection of the patients is the basis for good methodological studies on the course of IBD.A great proportion of data on the course of IBD is derived from a limited number of cohort *** help to define the endpoints for clinical trials and to identify subsets of patients in whom the prognosis of the disease can be stratified according to clinical *** scientific requirements for high-quality studies on prognosis are the following:use of inception cohort,description of referral patterns,completeness of follow-up,objective outcome criteria,blind outcome assessment,adjustment for extraneous prognostic factors and statistical *** analyzed each of these requirements in studies on *** date,prospective and populationbased cohort studies are the standard for an unbiased assessment of prognosis.A better knowledge of the course of disease of chronic disorders ideally requires:(1) data from population-based studies,to avoid selection bias from referral centers in which patients with a more severe disease are usually treated;(2) inclusion of patients seen at the onset of the disease excluding misdiagnosed cases;and(3) follow-up from the onset of the disease to the end without dropouts.

关键词： Methodology Inflammatory bowel disease course Prognosis Population-based studies Prospective cohort studies

Comparison of long-term results of trabeculectomy to treat pseudoexfoliative glaucoma and primary open angle glaucoma

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International Journal of Ophthalmology(English edition) 2018年第1期11卷 66-70页

作者： Vuslat Pelitli Gürlü Hande Gürlü Altan Ozal Omer Benian Levent Alimgil Department of Ophthalmology Trakya University Medical School Department of Ophthalmology Ekol Private Hospital Department of Ophthalmology Medicana Private Hospital

AIM： To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma（PEG） and primary open angle glaucoma（POAG） in terms of surgical success. METHODS： The success of the trabeculectomy was evaluated by three criteria. Criterion A： intraocular pressure（IOP） ≤21 mm Hg and decrease in IOP ≥20%; Criterion B： IOP ≤18 mm Hg and decrease in IOP ≥30%; Criterion C： IOP ≤15 mm Hg and decrease in IOP ≥50%. Patients that met these criteria without medical treatment were considered to be completely successful, while those that met these criteria with medical treatment were considered partially successful. Significance levels of differences between the POAG and PEG groups in the Kaplan-Meier survival curves were calculated with the log-rank test. RESULTS： Sixty-four eyes from 64 patients with PEG and 51 eyes from 51 patients with POAG were evaluated. No significant differences were detected between the PEG and POAG groups according to full or partial success relative to each of the three criteria（A： P=0.73, 0.32; B： P=0.73, 0.31; C：P=0.90, 0.27）. CONCLUSION： There is no difference in the long-term success of trabeculectomy between PEG and POAG patients whose clinical characteristics are otherwise the same.

关键词： primary open angle glaucoma pseudoexfoliative glaucoma trabeculectomy success

Case of takotsubo cardiomyopathy after surgical treatment of liver hydatid cyst: A case report

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World Journal of Clinical Cases 2023年第29期11卷 7187-7192页

作者： Yakup Altaş Ülfet Abdullayeva Department of Cardiology Private Melikgazi HospitalKayseri 38030Turkey Department of General Surgery Private Melikgazi HospitalKayseri 38030Turkey

BACKGROUND Takotsubo cardiomyopathy,also called apical ballooning syndrome,is a disease that is often triggered by stress factors in postmenopausal women and mimics acute coronary *** aim of this article is to draw attention to takotsubo cardiomyopathy after surgical treatment of liver hydatid *** SUMMARY A 50-year-old diabetic and hypertensive female patient was evaluated preoperatively before general surgery for liver hydatid cyst,and no cardiac problems were *** patient was discharged on the 3rd postoperative day without any postoperative *** postoperative day 5,the patient presented to the emergency department with fever,shortness of breath,chills,and shivering and was hospitalized with the diagnosis of *** troponin levels remained high during *** was performed on postoperative day 7,after which the patient was referred to a tertiary center with the diagnosis of non-ST-elevation myocardial infarction due to akinesia in the apical *** angiography performed at the tertiary center showed normal coronary anatomy,and the patient was diagnosed with takotsubo *** Takotsubo cardiomyopathy mimicking myocardial infarction without ST segment elevation may develop after surgical treatment of liver hydatid cyst.

关键词： Takotsubo cardiomyopathy Liver hydatid cyst Noncardiac surgery Coronary angiography Echocardiography Case report

Commercially available probiotic drinks containing Lactobacillus casei DN-114001 reduce antibiotic-associated diarrhea

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World Journal of Gastroenterology 2014年第42期20卷 15837-15844页

作者： Christoph G Dietrich Tanja Kottmann Manuela Alavi Department of Medicine Bethlehem Hospital Teaching Hospital of Aachen University RWTH private Institute of Medical Statistics

AIM: To investigate the effect of Lactobacillus-containing commercially available probiotic formulations in Germany during antibiotic treatment with an analysis of cost-efficiency.

关键词： Antibiotics-associated diarrhea Probiotics Lactobacillus casei

Stem cells:An eventual treatment option for heart diseases

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World Journal of Stem Cells 2015年第8期7卷 1118-1126页

作者： Joseph C Bilgimol Subbareddy Ragupathi Lakshmanan Vengadassalapathy Nathan S Senthil Kali-muthu Selvakumar M Ganesan Sadananda Rao Manjunath Micro Therapeutic Research Labs private Limited KMS Health Centre private Limited Chettinad hospital Thermo Fisher Scientific India private Limited

Stem cells are of global excitement for various diseases including heart diseases. It is worth to understand the mechanism or role of stem cells in the treatment of heart failure. Bone marrow derived stem cells are commonly practiced with an aim to improve the function of the heart. The majority of studies have been conducted with acute myocardial infarction and a few has been investigated with the use of stem cells for treating chronic or dilated cardiomyopathy. Heterogeneity in the treated group using stem cells has greatly emerged. Ever increasing demand for any alternative made is of at most priority for cardiomyopathy. Stem cells are of top priority with the current impact that has generated among physicians. However,meticulous selection of proper source is required since redundancy is clearly evident with the present survey. This review focuses on the methods adopted using stem cells for heart diseases and outcomes that are generated so far with an idea to determine the best therapeutic possibility in order to fulfill the present demand.

关键词： Bone marrow stem cells Mesenchymal stem cells Indu

Clinical variants of pityriasis rosea

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World Journal of Clinical Cases 2017年第6期5卷 203-211页

作者： Francisco Urbina Anupam Das Emilio Sudy Dermatologists in private Practice Dermatology KPC Medical College and Hospital

Pityriasis rosea(PR) is a common erythemato-squamous dermatosis which almost always, is easily diagnosed. Mostly the disease presents in its classical form. However, clinical dermatology is all about variations and PR is not an exception. Variants of the disease in some cases may be troublesome to diagnose and confuse clinicians. Prompt diagnosis and treatment of the condition becomes necessary to avoid unnecessary investigations. We hereby review and illustrate atypical presentations of the disease, including diverse forms of location and morphology of the lesions, the course of the eruption, and its differential diagnoses.

关键词： Pityriasis Pityriasis rosea Pityriasis rosea of Gibert Herald patch Papulo-squamous dermatosis

An open-label pilot study with high-dose thiamine in Parkinson's disease

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Neural Regeneration Research 2016年第3期11卷 406-407页

作者： Antonio Costantini Roberto Fancellu Department of Neurological Rehabilitation "Villa Immacolata" Clinic Unit of Neurology IRCCS San Martino University Hospital IST

Parkinson’s disease（PD）is a progressive neurodegenerative disorder clinically characterized by motor symptoms（bradykinesia,tremor,rigidity,postural instability）and non-motor symptoms（hyposmia,sleep disorders,aut... 详细信息

关键词： label tremor autonomic instability pilot fatigue rigidity progressive paired dopamine

Surgical management of non-syndromic ectopia lentis

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International Journal of Ophthalmology(English edition) 2020年第7期13卷 1156-1160页

作者： Kirk AJ Stephenson Michael O’Keefe David J Keegan Retinal Research Group Mater Misericordiae University Hospital&Mater Private HospitalDublin 7Ireland

AIM:To compare whether aphakic contact lenses or secondary iris-claw intraocular lenses are superior in the refractive management post-pars plana vitreolensectomy in a pedigree with an FBN1 mutation causing non-syndromic ectopia lentis(NSEL)with retinal detachment(RD).METHODS:Eight affected individuals had pars plana vitreolensectomy for bilateral ectopia lentis(EL).Twelve eyes of 6 patients had secondary iris-claw intraocular lenses inserted and 4 eyes of 2 patients were managed with contact *** retinal detachment(RRD)was treated when ***-and post-operative assessment included visual acuity,endothelial cell count and dilated fundal ***:Macula-on RRD was present in all individuals>18 y,64%(7/11 eyes)presenting post-vitreolensectomy with 57%having bilateral non-synchronous *** aphakia was managed with iris-fixated intraocular lenses(IOL group,n=6),or contact lenses(CL group,n=2).Visual acuity≥0.3 log MAR(driving standard)was achieved in 75%of IOL group eyes and 25%of the CL group *** loss of corneal endothelial cell count in the IOL group was 4%at 2 y ***:In this cohort,refractive management with iris-claw IOLs provided superior outcomes to contact lenses and the authors recommend this as the optimal refractive correction in EL patients.

关键词： FBN1 isolated ectopia lentis retinal detachment iris-claw intraocular lenses