检索结果-南通市图书馆

Role of capsule endoscopy in suspected celiac disease: A European multi-centre study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第4期23卷 703-711页

作者： Marisol Luján-Sanchis Enrique Pérez-Cuadrado-Robles Javier Garcia-Lledo José-Francisco Juanmartinena Fernandez Luca Elli Victoria-Alejandra Jiménez-García Juan Egea-Valenzuela Julio Valle-Munoz Cristina Carretero-Ribón Ignacio Fernández-Urién-Sainz Antonio López-Higueras Noelia Alonso-Lazaro Mileidis Sanjuan-Acosta Francisco Sanchez-Ceballos Bruno Rosa Santiago González-Vázquez Federica Branchi Lucía Ruano-Díaz César Prieto-de-Frías Vicente Pons-Beltrán Pilar Borque-Barrera Begona González-Suárez Sofía Xavier Federico Argüelles-Arias Juan-Manuel Herrerías-Gutiérrez Enrique Pérez-Cuadrado-Martínez Javier Sempere-García-Argüelles Digestive diseases Unit General University Hospital of Valencia small bowel Unit Hospital Morales Meseguer Digestive diseases Unit General University Gregorio Maranón Unit of Gastroenterology and Endoscopy Complejo Hospitalario de Navarra center for prevention and Diagnosis of Celiac Disease Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Unit of Gastroenterology and Endoscopy University Hospital Virgen Macarena Gastroenterology department Hospital Virgen de la Arrixaca Department of Gastroenterology Complejo Hospitalario de Toledo Department of Gastroenterology University of Navarra Clinic1 Endoscopy Digestive Unit Digestive Diseases AreaUniversitari i Politècnic La Fe Hospital1 Digestive diseases Unit University Hospital Nuestra Senora de Candelaria1 Digestive diseases Unit Clinical Hospital San Carlos1 Digestive diseases Unit Hospital da Senhora da Oliveira-Guimaraes1 Endoscopy Digestive Unit Hospital Clinic de Barcelona

AIMTo analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE).METHODSThis is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were *** overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated *** has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.

关键词： Capsule endoscopy Celiac disease Anti-transglutaminase antibodies Gluten-free diet Non-celiac gluten sensitivity

Ever-increasing diversity of drug-induced pancreatitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2020年第22期26卷 2902-2915页

作者： Simcha Weissman Muhammad Aziz Ryan B Perumpail Tej I Mehta Rutwik Patel James H Tabibian Department of Medicine Hackensack University-Palisades Medical CenterNorth BergenNJ 07047United States Department of Medicine University of Toledo Medical CenterToledoOH 43614United States Vatche and Tamar Manoukian Division of Digestive diseases David Geffen School of Medicine at UCLALos AngelesCA 90095United States Department of Interventional Radiology Johns Hopkins University HospitalBaltimoreMD 21205United States Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCA 91342 and David Geffen School of Medicine at UCLALos AngelesCA 90095United States

With over 100000 hospital admissions per annum,acute pancreatitis remains the leading gastrointestinal cause of hospitalization in the United States and has farreaching impact well *** has become increasingly recognized that druginduced pancreatitis(DIP),despite accounting for less than 3%of all cases,represents an important and growing though often inconspicuous cause of acute ***,knowledge of DIP is often curtailed by the limited availability of evidence needed to implicate given agents,especially for nonprescription ***,the majority of available data is derived from case reports,case series,or case control ***,the mechanism of injury and causality for many of these drugs remain elusive as a definitive correlation is generally not established(<10%of cases).Several classification systems have been proposed,but no single system has been widely adopted,and periodic updates are required in light of ongoing pharmacologic ***,infrequently prescribed medications or those available over-thecounter(including herbal and other alternative remedies)are often overlooked as a potential culprit of acute ***,we review the ever-increasing diversity of DIP and the potential mechanisms of injury with the goal of raising awareness regarding the nature and magnitude of this *** believe this manuscript will aid in increasing both primary and secondary prevention of DIP,thus ultimately facilitating more expedient diagnosis and a decrease in DIPrelated morbidity.

关键词： Drug-induced pancreatitis Acute pancreatitis Pharmacology Mechanism of action Inflammation Etiology

Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第25期22卷 5780-5789页

作者： Edward Wolfgang Lee Andrew Kuei Sammy Saab Ronald W Busuttil Francisco Durazo Steven-Huy Han Mohamed M El-Kabany Justin P Mc Williams Stephen T Kee Department of Radiology Division of Interventional Radiology Ronald Reagan Medical Center at UCLA David Geffen School of Medicine at UCLA Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Dumont-ucla Transplant center Pfleger Liver Institute Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at University of California Los Angeles

AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 ***: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and ***: Overall, 12.3% of patients died during hospitalization with downward trend in-hospital mortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients (OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients (OR = 1.347 vs non-transferred, P < 0.001), emergency admissions (OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region (OR = 1.449 vs West, P < 0.001) had significantly higher odds of in-hospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death (OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure (OR = 8.246), acute kidney failure (OR = 4.359), hepatic encephalopathy (OR = 2.217) and esophageal variceal bleeding (OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites (OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders (OR = 2.823), coagulopathy (OR = 2.016), and lymphoma (OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is stea

关键词： Transjugular intrahepatic portosystemic shunt Mortality Inpatient United States National Inpatient Sample database Health Cost and Utilization Project

Hemobilia: Etiology, diagnosis, and treatment

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Liver Research 2018年第4期2卷 200-208页

作者： Rani Berry James Han Ani A.Kardashian Nicholas F.LaRusso James H.Tabibian Department of Internal Medicine UCLA Ronald Reagan Medical CenterLos AngelesCAUSA Department of Internal Medicine University of California IrvineIrvineCAUSA ucla Gastroenterology Fellowship Training Program Vatche and Tamar ManoukianDivision of Digestive DiseasesLos AngelesCAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal *** of hemobilia date back to the 1600s,but due to its relative rarity and challenges in diagnosis,only in recent decades has hemobilia been more critically *** majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver,pancreas,bile ducts and/or the hepatopancreatobiliary vasculature,with trauma and malignancy rep-resenting the two other leading causes.A classic triad of right upper quadrant pain,jaundice,and overt upper gastrointestinal bleeding has been described(***'s triad),but this is present in only 25%e30%of patients with ***,prompt diagnosis depends critically on having a high index of suspicion,which may be based on a patient's clinical presentation and having recently undergone(peri-)biliary instrumentation or other predisposing *** treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic,interventional radiologic,or surgical *** we provide a clinical overview and update regarding the eti-ology,diagnosis,and treatment of hemobilia geared for specialists and subspecialists alike.

关键词： Hemobilia Upper gastrointestinal hemmorhage Etiology Diagnosis Imaging Hepatopancreatobiliary interventions

Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2017年第10期23卷 1735-1746页

作者： Murad Feroz Bandali Anirudh Mirakhur Edward Wolfgang Lee Mollie Clarke Ferris David James Sadler Robin Ritchie Gray Jason Kam Wong Department of Radiology Foothills Medical Centre University of Calgary Division of Interventional Radiology Department of Radiology UCLA Medical Center

Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.

关键词： Portal hypertension Diagnostic imaging Portosystemic collaterals Image-guided therapy

Challenges of Sustaining Malaria Community Case Management in 81 Township Hospitals along the China-Myanmar Border Region—Yunnan Province,China,2020

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

China CDC weekly 2021年第17期3卷 355-359页

作者： Wei Ding Shenning Lu Qiuli Xu Xuejiao Ma Bei Wang Jingbo Xue Xiaodong Sun Jianwei Xu Chris Cotter Duoquan Wang Yayi Guan Ning Xiao National Institute of Parasitic diseases Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research)NHC Key Laboratory of Parasite and Vector BiologyWHO Collaborating Centre for Tropical DiseasesNational Center for International Research on Tropical DiseasesShanghaiChina Yunnan Institute of Parasitic diseases PuerYunnanChina Malaria Elimination Initiative Institute for Global Health SciencesUniversity of CaliforniaSan FranciscoCAUSA.

Summary What is already known on this topic?The health workforce at township hospitals in the China-Myanmar border region has played a key role in sustaining Community case management of malaria(CCMm),while few studies have investigated their performance and *** is added by this report?Sustaining CCMm in the region was subject to the following major challenges.

关键词： Myanmar township challenges

Focus on Dysregulated Adaptive Immunity in Chronic Hepatitis B:A Promising Direction for Immunotherapy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Infectious Microbes & diseases 2022年第1期4卷 7-12页

作者： Jiaming Zhou Chunhong Huang Haihong Zhu Zhi Chen State Key Laboratory for Diagnosis and Treatment of Infectious diseases National Clinical Research Center for Infectious DiseasesNational Medical Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang China

Hepatitis B virus(HBV)infection is a public health problem that endangers global health and is the leading cause for the occurrence and death due to hepatocellular *** nucleotide analogs are excellent in controlling virus replication,they have little effect on the production,stability,and transcription of covalently closed circular DNA(cccDNA)in infected ***,only a small fraction of patients with chronic hepatitis B are cured by interferon *** HBV infection,HBV-specific B cells and T cells are ***-specific T cells exert antiviral effects through cell lysis and non-cytolytic effector functions,reducing viral intermediates and *** addition,HBV-specific B cells produce antibodies that eliminate HBV-infected liver cells through antibody-dependent cell-mediated cytotoxicity of natural killer *** can also bind to the hepatitis B surface antigen on the surface of the virus particle,inducing antibody-dependent phagocytosis by Kupffer *** responses could be combined with immunotherapy based on antiviral therapy,which may achieve a complete cure for hepatitis ***,patients with chronic hepatitis B have immune dysfunctions,which challenges immunotherapy *** review focuses on advances in adaptive immunotherapy for chronic viral hepatitis B.

关键词： hepatitis B virus chronic hepatitis B antiviral therapy immunotherapy immune checkpoint inhibitor vaccine cell therapy

Computed tomographic colonography:Hope or hype?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2010年第8期16卷 915-920页

作者： Otto Schiueh-Tzang Lin Digestive diseases Institute Virginia Mason Medical Center Department of Medicine University of Washington School of Medicine

Computed tomographic colonography (CTC) is a promising emerging technology for imaging of the colon. This concise review discusses the currently available data on CTC technique,test characteristics,acceptance,safety,cost-effectiveness,follow-up strategy,and extracolonic findings. In summary,CTC technique is still evolving,and further research is needed to clarify the role of automated colonic insufflation,smooth-muscle relaxants,intravenous and oral contrast,soft-ware rendering,and patient positioning. Currently,full bowel preparation is still required to achieve optimal results. The sensitivity for detecting large polyps (> 1 cm) can be as high as 85%,with specificity of up to 97%. These test characteristics are almost comparable to those of conventional colonoscopy. Patient acceptance of CTC is generally higher than that for colonoscopy,especially in patients who have never undergone either procedure. CTC is generally safe,although uncommon instances of colonic perforation have been documented. In terms of cost-effectiveness,most decision analyses have concluded that CTC would only be cost-effective if it were considerably cheaper than conventional colonoscopy. The proper follow-up strategy for small polyps or incidental extracolonic findings discovered during CTC is still under debate. At present,the exact clinical role of virtual colonoscopy still awaits determination. Even though widespread CTC screening is not available today,in the future there may eventually be a role for this technology. Technological advances in this area will undoubtedly continue,with multi-detector row CT scanners allowing thinner collimation and higher reso-lution images. Stool-tagging techniques are likely to evolve and may eventually allow for low-preparation CTC. Perceptual and fatigue-related reading errors can potentially be minimized with the help of computer-aided detection software. Further research will define the exact role of this promising technology in our diagnostic armame

关键词： Computed tomographic colonography Colonoscopy Colonic neoplasms Cancer screening Colonic polyps

Role of endoscopy in the management of primary sclerosing cholangitis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2019年第2期11卷 84-94页

作者： Neil Bharat Marya James H Tabibian Vatche and Tamar Manoukian Division of Digestive diseases UCLA Gastroenterology Fellowship Training Program Division of Gastroenterology Department of Medicine Olive View-UCLA Medical Center

Primary sclerosing cholangitis(PSC) is a rare but prominent fibroinflammatory cholangiopathy which can affect individuals of essentially any age. It carries a median survival of 15-20 years, regardless of age at diagnosis, and is a foremost risk factor for cholangiocarcinoma. Given the chronic and progressive nature of PSC, its inherent risk for biliary tract and other complications, and the paucity of effective pharmacotherapies, endoscopy plays a major role in the care of many patients with this disorder. In this review, we discuss the endoscopic management of PSC, including established and evolving approaches to the diagnosis and treatment of its benign as well as malignant sequelae. Owing to the rarity of PSC and dearth of high-quality evidence, we propose pragmatic approaches based on both currently available data and expert opinion.

关键词： Bile duct diseases Cholangiocarcinoma Inflammatory bowel disease Endoscopic retrograde cholangiopancreatography Biopsy Primary sclerosing cholangitis