Dm Disease-A-Month最新文献

英文中文

Gastrointestinal disorders–Clinical challenges for the primary care clinician: Conclusion 胃肠道疾病-初级保健临床医生的临床挑战：结论。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101827

Robin B. McFee DO, MPH, FACPM, FAACT

引用次数: 0

Gastrointestinal disorders – Clinical challenges for the primary care clinician An overview 胃肠道疾病-初级保健临床医生的临床挑战综述。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101829

Robin McFee DO, MPH, FACPM, FAACT (Medical Director) , Jerrold B. Leikin MD, FACOEM, FACP, FACEP, FACMT, FAACT, FASAM (Senior Editor)

引用次数: 0

Navigating mesenteric vasculitis: A comprehensive review of literature 肠系膜血管炎导航：文献综述。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101830

Fizza Zulfiqar MD , Muhammad Bilal MD , Yash Shah MD , Steele Morgan , Rida Fatima MD , Bryanna Singh , Sneha Annie Sebastian , Bashar Roumia , Parjanya Bhatt MD , Vinay Kumar Thallapally MD , Geetha Krishnamoorthy MD , Syed Ali Muttaqi Hussain MD

Vasculitides are diseases marked by inflammation of the blood vessel walls across various organ systems. The mesenteric vasculitis (MV) affects localized mesenteric vessels of the gastrointestinal tract. It usually occurs as part of a systemic inflammatory process but could also present in isolation. There are very few published reports of isolated mesenteric artery vasculitis. Presenting symptoms often include nausea, vomiting, diarrhea, abdominal pain, rectal bleeding, often complicating the diagnostic process. Diagnosing MV as the cause of abdominal pain can be challenging, and failure to diagnose can result in significant morbidity and mortality. A timely and accurate diagnosis of MV is essential for administering the appropriate immunosuppressive therapy and preventing unnecessary surgical interventions. This review aims to provide a comprehensive discussion of MV, including its clinical presentation, diagnostic approaches, and treatment options, with a focus on achieving early diagnosis to enhance outcomes and prevent complications. Furthermore, this review addresses the diagnostic challenges associated with MV, including the lack of specific criteria and symptom overlap with other gastrointestinal disorders such as atherosclerotic mesenteric ischemia, infections, malignancies, adverse medication effects, and other vessel occlusive processes. It also emphasizes the gaps in current literature regarding optimal diagnostic strategies and the necessity for standardized treatment protocols. By addressing these gaps and challenges, we aim to optimize patient care and improve prognosis for individuals affected by MV.

血管炎是以各器官系统血管壁发炎为特征的疾病。肠系膜血管炎（MV）影响胃肠道的局部肠系膜血管。它通常是全身炎症过程的一部分，但也可能单独出现。关于孤立性肠系膜动脉血管炎的公开报道很少。出现的症状通常包括恶心、呕吐、腹泻、腹痛和直肠出血，这往往使诊断过程复杂化。诊断腹痛的病因为 MV 可能具有挑战性，诊断失败可能导致严重的发病率和死亡率。及时准确地诊断出中风对采取适当的免疫抑制疗法和防止不必要的手术干预至关重要。本综述旨在全面讨论中风，包括其临床表现、诊断方法和治疗方案，重点是实现早期诊断以提高疗效和预防并发症。此外，本综述还探讨了与 MV 相关的诊断难题，包括缺乏特定标准和症状与其他胃肠道疾病重叠，如动脉粥样硬化性肠系膜缺血、感染、恶性肿瘤、药物不良反应和其他血管闭塞过程。报告还强调了当前文献在最佳诊断策略方面存在的不足，以及标准化治疗方案的必要性。通过解决这些差距和挑战，我们的目标是优化患者护理，改善中风患者的预后。

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引用次数: 0

Cannabinoid Hyperemesis Syndrome (CHS) - An emerging gastrointestinal disorder and clinical challenge 大麻素呕吐综合征——一种新兴的胃肠道疾病和临床挑战。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101832

R.B. McFee DO, MPH, FACPM, FAACT

Nausea and vomiting are not uncommon symptoms resulting in emergency department (ED) or primary care visits. One of the emerging etiologies – Cannabinoid Hyperemesis Syndrome (CHS) remains significantly under-diagnosed, often resulting in unnecessary repeat ED visits and testing. This is in part due to lack of experience with and knowledge about CHS by health care professionals. Characterized by cyclic vomiting, often severe and intractable, it is frequently associated with a form of self-treatment; the compulsive need to take hot showers, and in the context of chronic cannabis use. With increased legalization and resultant accessibility to cannabis containing products, the risk of adverse events is significantly rising. Lack of clinical familiarity with the range of potential deleterious physical and mental health effects associated with cannabis leads to delays in appropriate diagnosis and effective treatment of CHS. Moreover, commonly utilized anti-emetics, such as ondansetron, and similar 5 HT drugs may not fully attenuate symptoms of CHS, and other interventions may be necessary; ultimately abstinence being the most effective long term clinical preventive approach. The objective of this review article is to assist the clinician in identifying the specific clinical characteristics of CHS, distinguishing it from other causes of CVS or nausea and vomiting, to facilitate more rapid, effective interventions. Collaboration with substance use professionals should also be considered during CHS treatment.

恶心和呕吐是不常见的症状导致急诊科（ED）或初级保健访问。新出现的病因之一-大麻素剧吐综合征（CHS）仍然明显诊断不足，经常导致不必要的重复ED访问和测试。这部分是由于卫生保健专业人员缺乏关于CHS的经验和知识。以周期性呕吐为特征，通常严重且难治性，常伴有某种形式的自我治疗；强迫性地需要洗热水澡，在长期使用大麻的情况下。随着大麻合法化程度的提高以及由此产生的含大麻产品的可及性，不良事件的风险正在显著上升。缺乏对与大麻有关的潜在有害身心健康影响范围的临床熟悉，导致对大麻中毒的适当诊断和有效治疗出现延误。此外，常用的止吐剂，如昂丹司琼和类似的5ht药物可能不能完全减轻CHS的症状，其他干预措施可能是必要的；最终，禁欲是最有效的长期临床预防方法。这篇综述文章的目的是帮助临床医生识别CHS的具体临床特征，将其与CVS或恶心和呕吐的其他原因区分开来，以促进更快速，更有效的干预。在CHS治疗期间还应考虑与物质使用专业人员合作。

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引用次数: 0

Lactose Intolerance – A practical approach, Part 2 An approach to foods 乳糖不耐症-一个实用的方法，第2部分：食物的方法。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101824

Michael Mallary PhD, FIEEE

引用次数: 0

Information for Readers

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/S0011-5029(24)00163-9

引用次数: 0

Lactose intolerance – A practical approach, Part 1 乳糖不耐症-一个实用的方法，第1部分。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101823

RB McFee DO, MPH, FACPM, FAACT

The toxicology, immunology and gastroenterology aspects of food remain important in clinical practice, as anyone treating food related anaphylaxis, or chronic intolerance syndromes can attest. Although entire editions of journals could focus on any one aspect of adverse effects from food, the following review addresses the important and prevalent gastrointestinal condition lactose intolerance and gastrointestinal (GI) conditions that have similar presentation but require different treatment.

食物的毒理学、免疫学和胃肠病学方面在临床实践中仍然很重要，任何治疗食物相关过敏反应或慢性不耐受综合征的人都可以证明这一点。虽然期刊的整个版本可以关注食物的任何一个方面的不良反应，但以下的综述讨论了乳糖不耐症和胃肠道（GI）疾病的重要和普遍的胃肠道疾病，它们具有相似的表现，但需要不同的治疗。

引用次数: 0

Gastrointestinal disorders – Clinical challenges for the primary care clinician 胃肠道疾病-初级保健临床医生的临床挑战。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101828

Robin B. McFee DO, MPH, FACPM, FAACT

Gastrointestinal (GI) associated symptoms are among the most common medical concerns resulting in visits to primary and specialty care. Especially challenging is the wide range of causative disorders and exposures associated with symptoms ranging from mild to life threatening - from within the GI tract as well as extra-gastrointestinal. Some of these are well described, and common, including infections, while others are newly emerging, such as cannabinoid hyperemesis syndrome. Others are well known but clinical success can remain elusive, such as food associated GI disorders - lactose intolerance and related. Although entire references have been written to address gastrointestinal diseases, in this edition of Disease a Month we will address some of the more challenging GI disorders; some of which are common but often difficult to control - food associated for example, and emerging GI illnesses such as radiation or cannabinoid hyperemesis, that lead patients to the Emergency Department, primary care clinician or specialty referral. What follows is a discussion of diverse but clinically important GI disorders, and the newer therapeutic strategies to help patients better manage their symptoms, and improve their quality of life.

胃肠道（GI）相关症状是最常见的医疗问题，导致访问的初级和专科护理。尤其具有挑战性的是各种各样的致病疾病和与症状相关的暴露，从轻微到危及生命——从胃肠道内到胃肠道外。其中一些是很好的描述，常见的，包括感染，而其他是新出现的，如大麻素呕吐综合征。还有一些是众所周知的，但临床成功仍然难以捉摸，比如食物相关的胃肠道疾病——乳糖不耐症和相关疾病。虽然所有的参考文献都是关于胃肠道疾病的，但在本期的《疾病一个月》中，我们将讨论一些更具挑战性的胃肠道疾病；其中一些是常见的，但往往难以控制——例如，与食物有关的，以及新出现的胃肠道疾病，如辐射或大麻素呕吐，这些疾病会导致患者去急诊室、初级保健临床医生或专科转诊。以下是对各种临床重要的胃肠道疾病的讨论，以及帮助患者更好地控制症状和提高生活质量的新治疗策略。

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引用次数: 0

Nausea and vomiting – General considerations 恶心和呕吐——一般注意事项。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/j.disamonth.2024.101831

Robin B. McFee D.O., M.P.H., FACPM, FAACT , George G. Abdelsayed M.D., FACP, FACG, CHCQM

引用次数: 0

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IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2024-12-01 DOI: 10.1016/S0011-5029(24)00162-7

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