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A Case of Foreign Body in the Biliary Tree and the Challenge of Hypereosinophilia 胆道树内异物1例及嗜酸性细胞增多症的挑战
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-10-01 DOI: 10.3390/gidisord5040035
Emanuele Sinagra, Francesco Vito Mandarino, Francesca Rossi, Rita Alloro, Sergio Testai, Marta Marasà, Serena Cristofalo, Marcello Maida, Daniele Brinch, Giuseppe Conoscenti, Ernesto Fasulo, Dario Raimondo
In all reported cases of foreign body migration or impaction in the biliary tree, there is no mention of the presence of hypereosinophilia among the laboratory findings. This could possibly be attributed to the local tissue reaction caused by the impacted foreign body. Here, we present our experience with the removal of a screw from a surgical retractor that became lodged in the common bile duct (CBD) and migrated in a patient who had previously undergone a left lateral hepatectomy for hepatic hydatidosis. The imaging was not sufficient to make a diagnosis, and the interpretation of hypereosinophilia in such a case could pose a challenge.
在所有报告的胆道异物迁移或嵌顿的病例中,在实验室检查结果中没有提到嗜酸性细胞增多症的存在。这可能是由于异物撞击引起的局部组织反应。在这里,我们介绍了我们的经验,从手术牵开器中取出螺钉,该螺钉卡在胆总管(CBD)中并移动,该患者先前因肝包囊病接受了左侧肝切除术。成像不足以做出诊断,在这种情况下嗜酸性细胞增多症的解释可能会带来挑战。
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引用次数: 0
Assessing the Relationship between Gastrointestinal and Pancreatic Neuroendocrine Tumor Grade and Overall Survival: A Systematic Review and Meta-Analysis 评估胃肠道和胰腺神经内分泌肿瘤分级与总体生存之间的关系:一项系统回顾和荟萃分析
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-09-18 DOI: 10.3390/gidisord5030033
Preeti Malik, Neel Patel, Azadeh Khayyat, Muhammad Asad, Sameer Dawoodi, Sangeetha Chandramohan, Nkechi Unachukwu, Bibimariyam Nasyrlaeva, Laseena Vaisyambath, Sriram B. Chowdary, Vikramaditya Samala Venkata, Urvish Patel
Background: Neuroendocrine tumors (NET) are a rare group of epithelial neoplasms present in the gastrointestinal tract (GI) (67.5%) and bronchopulmonary tree (25.3–30%), and in 15% of cases, their primary sites cannot be identified. Although endoscopic screening, improvements in pathological techniques, and early detection have shown improvements in NET survival rates, the prognosis of advanced, metastatic, and poorly differentiated NET is very poor. In this study, we aimed to evaluate the effect of gastrointestinal and pancreatic (GEPs) NETs’ grade on overall survival. Method: We searched observational studies describing the overall survival or prognostic factors of primary GEP NETs from May 2011–May 2021 following the PRISMA guidelines. Studies describing the effect of primary grade 3 GEP NETs on overall survival were included. A meta-analysis was performed, and a pooled hazard ratio and their 95% confidence interval (95% CI) were obtained. Forest plots were created using random effects models and a sensitivity analysis was performed to account for the heterogeneity. Results: Seven studies with 7692 confirmed patients were included. In our meta-analysis, grade 3 GEP NETs were associated with higher odds of poor survival (pooled HR: 2.73; 95% CI: 1.36–5.47; p = 0.005), with a 92% heterogeneity between studies (p < 0.0001). To account for this heterogeneity, a sensitivity analysis was performed by removing two outlying studies (Fathi et al. and Foubert et al.) on funnel plots. The results after the sensitivity analysis did not change and still showed a significant association of grade 3 with a poor survival (pooled HR: 4.53; 95% CI: 3.54–5.78; p < 0.00001), with no heterogeneity between studies (p = 0.72; I2 = 0%). Conclusions: Our meta-analysis found that grade 3 GEP NETs are associated with poor survival and additional future studies are needed to identify other risk factors associated with poor survival in GEP NETs to improve their mortality.
背景:神经内分泌肿瘤(NET)是一组罕见的上皮性肿瘤,存在于胃肠道(GI)(67.5%)和支气管肺树(25.3-30%),其中15%的病例原发部位无法确定。虽然内窥镜筛查、病理技术的改进和早期发现已经显示出NET生存率的提高,但晚期、转移性和低分化NET的预后非常差。在这项研究中,我们旨在评估胃肠道和胰腺(GEPs) NETs的分级对总生存期的影响。方法:我们根据PRISMA指南检索了2011年5月至2021年5月期间描述原发性GEP NETs总生存期或预后因素的观察性研究。研究描述了初级3级GEP NETs对总生存率的影响。进行荟萃分析,获得合并风险比及其95%置信区间(95% CI)。使用随机效应模型创建森林样地,并进行敏感性分析以解释异质性。结果:纳入7项研究,共7692例确诊患者。在我们的荟萃分析中,3级GEP NETs与较高的生存不良几率相关(合并风险比:2.73;95% ci: 1.36-5.47;P = 0.005),研究间存在92%的异质性(P <0.0001)。为了解释这种异质性,通过删除漏斗图上的两个外围研究(Fathi et al.和Foubert et al.)进行敏感性分析。敏感性分析后的结果没有改变,仍然显示3级与生存不良有显著关联(合并风险比:4.53;95% ci: 3.54-5.78;p & lt;0.00001),研究间无异质性(p = 0.72;I2 = 0%)。结论:我们的荟萃分析发现,3级GEP NETs与较差的生存率相关,需要进一步的研究来确定与GEP NETs中较差生存率相关的其他危险因素,以提高其死亡率。
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引用次数: 0
Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review 内镜下挽救胃肠道吻合口渗漏——过去、现在和未来——述评
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-09-15 DOI: 10.3390/gidisord5030032
Alexandra Menni, George Stavrou, Georgios Tzikos, Anne D. Shrewsbury, Katerina Kotzampassi
Background: Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. Methods: A narrative review of the international literature took place, including PubMed, Scopus, and Google Scholar, utilizing specific search terms such as “Digestive Surgery AND Anastomotic Leakage OR leak OR dehiscence”. Results: In the present review, we try to describe and analyze the pros and cons of the various endoscopic techniques: from the very first (and still available), fibrin gluing, to endoclip and over-the-scope clip positioning, stent insertion, and the latest suturing and endoluminal vacuum devices. Finally, alongside efforts to improve the existing techniques, we consider stem cell application as well as non-endoscopic, and even endoscopic, attempts at intraluminal microbiome modification, which should ultimately intervene pre-emptively, rather than therapeutically, to prevent leaks. Conclusions: In the last three decades, this search for an ideal device for closure, which must be safe, easy to deploy, inexpensive, robust, effect rapid and stable closure of even large defects, and have a low complication rate, has led to the proposal and application of a number of different endoscopic devices and techniques. However, to date, there is no consensus as to the best. The literature contains reports of only small studies and no randomized trials, failing to take into account both the heterogeneity of leaks and their different anatomical sites.
背景:吻合口瘘是指两个中空脏器之间的手术连接完整性的缺陷,导致腔内腔室和腔外腔室之间的通信,它仍然是胃肠道手术后最令人恐惧的并发症之一,具有致命的潜在后果。手术治疗的选择是有限的,并且有很高的发病率和死亡率;因此,外科医生迫切需要寻找微创、可重复、非手术、不需要全身麻醉的替代方案。方法:对国际文献进行叙述性回顾,包括PubMed, Scopus和Google Scholar,使用特定的搜索词,如“消化道手术和吻合口渗漏或泄漏或开裂”。结果:在本综述中,我们试图描述和分析各种内镜技术的优缺点:从最初的(和仍然可用的),纤维蛋白粘接,到内夹和镜外夹定位,支架插入,以及最新的缝合和腔内真空装置。最后,在努力改进现有技术的同时,我们考虑干细胞应用以及非内窥镜,甚至内窥镜,对腔内微生物组修饰的尝试,这最终应该先发制人,而不是治疗性地干预,以防止泄漏。结论:在过去的三十年中,为了寻找一种理想的闭合装置,必须安全,易于部署,价格低廉,坚固耐用,即使是大的缺陷也能快速稳定地闭合,并且并发症发生率低,导致了许多不同的内镜设备和技术的提出和应用。然而,到目前为止,对于最好的方法还没有达成共识。文献中只包含小型研究报告,没有随机试验,没有考虑到泄漏的异质性和不同的解剖部位。
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引用次数: 0
Inflammatory Bowel Disease in Turkish Populations Served by English NHS Trusts 炎症性肠病在土耳其人口服务于英国NHS信托
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-09-13 DOI: 10.3390/gidisord5030031
Affifa Farrukh, John Francis Mayberry
It is estimated that there are about 500,000 Turkish people living in the UK, of whom about 300,000 are of Cypriot origin. A Freedom of Information request was sent to the four NHS Trusts in London which served areas with significant Turkish communities. The request sought information on the total number of patients admitted between 2016 and 2020 with inflammatory bowel disease. Between 2016 and 2020, 1936 patients with inflammatory bowel disease were admitted to North Middlesex University Hospital NHS Trust. Some of these patients will have been readmitted in different years, leading to an inflation of the overall number. The average number of cases admitted each year was approximately 387. The proportion of White British patients with ulcerative colitis was 0.4; for Turkish Cypriots, it was 0.43 and for Turkish patients, 0.45. A z test comparison of these proportions showed that there was no difference between the Turkish communities (z = 0.52 ns) and no overall difference between White British and all Turkish patients (z = −1.5, ns). Between 2016 and 2020, the Homerton Healthcare Foundation Trust admitted 215 English patients with inflammatory bowel disease, of whom 113 had ulcerative colitis. Of the 26 Turkish patients, 4 had ulcerative colitis. The proportion of Turkish patients with Crohn’s disease was significantly greater than that amongst English patients (z = 3.58, p < 0.0003). In the context of the relatively large number of Turkish people with inflammatory bowel disease in both trusts, the absence of published work on the impact of these chronic diseases is of concern. The results from this investigation should prompt specific qualitative research into the Turkish experience in the UK following a diagnosis of inflammatory bowel disease with the intention of developing better patient-centred care.
据估计,大约有50万土耳其人生活在英国,其中约30万是塞浦路斯裔。向伦敦的四个NHS信托基金发送了信息自由请求,这些信托基金为土耳其人社区提供服务。该请求寻求2016年至2020年期间因炎症性肠病入院的患者总数的信息。2016年至2020年间,有1936名炎症性肠病患者被送入北米德尔塞克斯大学医院NHS信托。其中一些病人会在不同的年份再次入院,导致总人数的膨胀。每年接收的平均病例数约为387例。英国白人溃疡性结肠炎患者的比例为0.4;土耳其裔塞浦路斯人为0.43,土耳其裔患者为0.45。这些比例的z检验比较显示,土耳其社区之间没有差异(z = 0.52 ns),白种英国人和所有土耳其患者之间没有总体差异(z = - 1.5 ns)。2016年至2020年期间,霍默顿医疗保健基金会信托接收了215名患有炎症性肠病的英国患者,其中113名患有溃疡性结肠炎。在26例土耳其患者中,4例患有溃疡性结肠炎。土耳其患者患克罗恩病的比例显著高于英国患者(z = 3.58, p <0.0003)。在这两个信托基金中患有炎症性肠病的土耳其人相对较多的背景下,缺乏关于这些慢性疾病影响的已发表工作令人担忧。这项调查的结果应该促进具体的定性研究土耳其在英国诊断炎症性肠病后的经验,目的是发展更好的以患者为中心的护理。
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引用次数: 0
Vedolizumab as Rescue Therapy in Carboplatin-Gemcitabine-Induced Triggered Acute Severe Ulcerative Colitis Flare-Up Vedolizumab作为卡铂-吉西他滨诱发的急性严重溃疡性结肠炎发作的拯救疗法
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-09-01 DOI: 10.3390/gidisord5030030
R. Pellegrino, M. Fasano, F. Morgillo, Giovanna Palladino, Isabella Vassallo, M. Pirozzi, G. Imperio, Salvatore Auletta, Andrea Ventura, I. Panarese, Alessandro Federico, A. Gravina
Approximately 20% of patients with ulcerative colitis (UC) develop acute severe UC (ASUC), for which intravenous systemic steroid therapy and possibly infliximab-based rescue therapy are generally imposed. However, there are no significant guideline recommendations on ASUC regarding vedolizumab as an alternative in this setting. A case report was presented where a patient with steroid-dependent UC developed ASUC induced by second-line chemotherapy. Treatment with intravenous methylprednisolone was imposed, but there was no reduction in bowel movements in the days following admission. Rescue therapy with infliximab was contraindicated because of the oncologic history. Surgical consultation, contraindicated colectomy, and administration of vedolizumab 300 mg were initiated. After infusion with vedolizumab, there was a significant reduction in bowel movements starting the day after infusion until normalisation of bowel movements within three days and the concomitant normalisation of inflammatory indices. The patient is currently in clinical remission, on therapy with vedolizumab 108 mg subcutaneously every two weeks, and is in oncologic follow-up for pulmonary neoplasm. This case highlights the novel potential of vedolizumab as a possible rescue therapy in ASUC, especially in special populations, where it may offer a better safety profile. Although cyclosporine and infliximab still represent the mainstays of salvage therapy for steroid-refractory ASUC, new therapeutic agents may also be effective, such as vedolizumab, ustekinumab, and anti-Janus kinase agents.
大约20%的溃疡性结肠炎(UC)患者发展为急性重症UC(ASUC),通常会进行静脉全身类固醇治疗和可能的英夫利昔单抗抢救治疗。然而,ASUC没有关于vedolizumab作为这种情况下的替代品的重要指南建议。一份病例报告显示,一名类固醇依赖性UC患者在二线化疗诱导下出现ASUC。采用静脉注射甲基强的松龙治疗,但在入院后几天内排便没有减少。因肿瘤病史,禁止使用英夫利昔单抗进行抢救性治疗。开始进行外科会诊、禁忌症结肠切除术和300mg维多利珠单抗给药。输注vedolizumab后,从输注后第二天开始,排便显著减少,直到三天内排便正常,同时炎症指数正常。该患者目前处于临床缓解期,每两周接受一次108 mg的维多利珠单抗皮下治疗,并正在接受肺部肿瘤的肿瘤学随访。该病例突出了韦多利珠单抗作为ASUC可能的挽救疗法的新潜力,特别是在特殊人群中,它可能提供更好的安全性。尽管环孢菌素和英夫利昔单抗仍然是类固醇难治性ASUC抢救治疗的主要支柱,但新的治疗剂也可能有效,如维多利珠单抗、ustekinumab和抗Janus激酶剂。
{"title":"Vedolizumab as Rescue Therapy in Carboplatin-Gemcitabine-Induced Triggered Acute Severe Ulcerative Colitis Flare-Up","authors":"R. Pellegrino, M. Fasano, F. Morgillo, Giovanna Palladino, Isabella Vassallo, M. Pirozzi, G. Imperio, Salvatore Auletta, Andrea Ventura, I. Panarese, Alessandro Federico, A. Gravina","doi":"10.3390/gidisord5030030","DOIUrl":"https://doi.org/10.3390/gidisord5030030","url":null,"abstract":"Approximately 20% of patients with ulcerative colitis (UC) develop acute severe UC (ASUC), for which intravenous systemic steroid therapy and possibly infliximab-based rescue therapy are generally imposed. However, there are no significant guideline recommendations on ASUC regarding vedolizumab as an alternative in this setting. A case report was presented where a patient with steroid-dependent UC developed ASUC induced by second-line chemotherapy. Treatment with intravenous methylprednisolone was imposed, but there was no reduction in bowel movements in the days following admission. Rescue therapy with infliximab was contraindicated because of the oncologic history. Surgical consultation, contraindicated colectomy, and administration of vedolizumab 300 mg were initiated. After infusion with vedolizumab, there was a significant reduction in bowel movements starting the day after infusion until normalisation of bowel movements within three days and the concomitant normalisation of inflammatory indices. The patient is currently in clinical remission, on therapy with vedolizumab 108 mg subcutaneously every two weeks, and is in oncologic follow-up for pulmonary neoplasm. This case highlights the novel potential of vedolizumab as a possible rescue therapy in ASUC, especially in special populations, where it may offer a better safety profile. Although cyclosporine and infliximab still represent the mainstays of salvage therapy for steroid-refractory ASUC, new therapeutic agents may also be effective, such as vedolizumab, ustekinumab, and anti-Janus kinase agents.","PeriodicalId":73131,"journal":{"name":"Gastrointestinal disorders (Basel, Switzerland)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41548993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Training in Pediatric Gastrointestinal Endoscopy during Surgery Residency: Can Training Programs Currently Educate Proficient Pediatric Endoscopists? A Nationwide Assessment 外科住院医师期间的儿科胃肠内镜培训:目前的培训计划能否培养出熟练的儿科内镜医师?全国评估
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-08-29 DOI: 10.3390/gidisord5030029
Giovanni Parente, Marco Di Mitri, T. Gargano, Mario Lima
Background: Technological advances in pediatric gastrointestinal (GI) endoscopy require highly specialized physicians. Therefore, proper training is fundamental. The aim of this study was to assess the level of competence of pediatric surgery residents to determine areas that should be addressed to design better training programs focused on pediatric GI endoscopy. Methods: An observational study was performed on all Italian pediatric surgery trainees that concluded the training program by the end of 2021, who were asked to answer a questionnaire about the quality of the GI endoscopy education received during their 5 years of residency. Results: 12 out 14 (86%) pediatric surgery trainees answered the questionnaire. A total of 50% (6/12) of the trainees declared they were interested in pediatric GI endoscopy, and 42% (5/12) said that they would be interested in dedicating themselves to this discipline in the future. Only 33% (4/12) of them were in a center equipped with endoscopy simulators. Among them, 17% (2/12) never took part in GI endoscopic procedures while working in centers in which GI endoscopy is performed exclusively by pediatric gastroenterologists, 25% (3/12) had never performed GI endoscopic procedures as a first operator and 17% (2/12) not even as assistant. Overall, 50% (6/12) were not satisfied with the level of education received and only 17% (2/12) declared that they felt confident enough to perform routine endoscopies alone. Conclusions: Our study highlights great inhomogeneity between different schools and some important failings. Better programs should be designed to educate proficient pediatric GI endoscopists.
背景:儿科胃肠道(GI)内窥镜检查的技术进步需要高度专业化的医生。因此,适当的培训是至关重要的。本研究的目的是评估儿科手术住院医师的能力水平,以确定应解决的领域,从而设计更好的以儿科胃肠镜为重点的培训计划。方法:对所有在2021年底前结束培训计划的意大利儿科手术受训人员进行了一项观察性研究,要求他们回答一份关于在住院5年期间接受胃肠道内窥镜检查教育质量的问卷。结果:14名儿科手术学员中有12名(86%)回答了问卷。共有50%(6/12)的受训者表示他们对儿科胃肠道内窥镜检查感兴趣,42%(5/12)的人表示他们有兴趣在未来致力于这一学科。只有33%(4/12)的患者在配备了内窥镜检查模拟器的中心。其中,17%(2/12)在儿童胃肠病学家专门进行胃肠道内镜检查的中心工作时从未参加过胃肠道内镜手术,25%(3/12)从未作为第一名操作员进行过胃肠道镜检查,17%(2/22)甚至没有作为助手进行过。总体而言,50%(6/12)的人对所接受的教育水平不满意,只有17%(2/12)表示他们有足够的信心单独进行常规内镜检查。结论:我们的研究强调了不同学校之间的巨大不均匀性和一些重要的失误。应该设计更好的项目来教育熟练的儿科胃肠道内窥镜医生。
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引用次数: 0
The Effect of COVID-19 on Gut Microbiota: Exploring the Complex Interplay and Implications for Human Health COVID-19对肠道微生物群的影响:探索复杂的相互作用及其对人类健康的影响
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-08-18 DOI: 10.3390/gidisord5030028
Shamima Akter, Sa’dia Tasnim, Rashu Barua, Mayank Choubey, Shahida Arbee, Mohammad Mohabbulla Mohib, Naofel Minhaz, Ajanta Choudhury, Pallab Sarker, Mohammad Sarif Mohiuddin
The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to significant global health implications. Although the respiratory manifestations of COVID-19 are widely recognized, emerging evidence suggests that the disease may also significantly affect the gut microbiota, the intricate community of bacteria that lives within the gastrointestinal system. This extensive article intends to investigate the impact of COVID-19 on the gut microbiota, examining the underlying mechanisms, clinical implications, and potential therapeutic interventions. Understanding the complex interactions between COVID-19 and the gut microbiota will help us to gain valuable insights into the broader consequences of this viral infection on human health.
由SARS-CoV-2病毒引起的COVID-19大流行对全球卫生造成了重大影响。尽管COVID-19的呼吸道表现得到了广泛认可,但新出现的证据表明,该疾病也可能显著影响肠道微生物群,即生活在胃肠道系统内的复杂细菌群落。本文旨在探讨COVID-19对肠道微生物群的影响,探讨其潜在机制、临床意义和潜在的治疗干预措施。了解COVID-19与肠道微生物群之间的复杂相互作用将有助于我们获得有关这种病毒感染对人类健康的更广泛后果的宝贵见解。
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引用次数: 0
The Effect of COVID-19 on Gut Microbiota: Exploring the Complex Interplay and Implications for Human Health 新冠肺炎对肠道微生物群的影响:探索复杂的相互作用及其对人类健康的影响
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-08-18 DOI: 10.20944/preprints202307.1326.v1
Shamima Akter, Sadia Tasnim, R. Barua, M. Choubey, Shahida Arbee, M. M. Mohib, Naofel Minhaz, Ajanta Choudhury, P. Sarker, Mohammad Sarif Mohiuddin
The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to significant global health implications. Although the respiratory manifestations of COVID-19 are widely recognized, emerging evidence suggests that the disease may also significantly affect the gut microbiota, the intricate community of bacteria that lives within the gastrointestinal system. This extensive article intends to investigate the impact of COVID-19 on the gut microbiota, examining the underlying mechanisms, clinical implications, and potential therapeutic interventions. Understanding the complex interactions between COVID-19 and the gut microbiota will help us to gain valuable insights into the broader consequences of this viral infection on human health.
由SARS-CoV-2病毒引起的新冠肺炎大流行已对全球健康产生重大影响。尽管新冠肺炎的呼吸道表现得到了广泛认可,但新出现的证据表明,该疾病也可能对肠道微生物群产生重大影响,肠道微生物群是生活在胃肠系统中的复杂细菌群落。这篇内容广泛的文章旨在研究新冠肺炎对肠道微生物群的影响,研究潜在的机制、临床意义和潜在的治疗干预措施。了解新冠肺炎与肠道微生物群之间的复杂相互作用,将有助于我们深入了解这种病毒感染对人类健康的更广泛影响。
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引用次数: 1
Chronic Kidney Disease Linked to Higher Incidence of Gastric Diseases 慢性肾脏病与胃病发病率高有关
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-08-17 DOI: 10.3390/gidisord5030027
Xiaoliang Wang, Zachary Wright, Jiayan Wang, Wesam M Frandah, G. Song
This study aimed to investigate the relationship between chronic kidney disease (CKD) and different gastric diseases by conducting a population-based retrospective analysis using National Inpatient Sample (NIS) data. A total of 7,159,694 patients diagnosed with gastric diseases with or without CKD were included, and the diagnoses of gastritis, gastric polyps, peptic ulcer disease (PUD), and Helicobacter pylori infection were based on ICD-10-CM codes. The study found a higher prevalence of gastritis and gastric polyps in patients with CKD compared to patients without CKD, especially in the late stages of CKD. After adjustment, patients with CKD also had a higher risk of developing these gastric diseases than patients without CKD. However, there was no significant association between all stages of CKD and PUD or Helicobacter pylori infection. These results underscored the importance of monitoring gastric health in patients with CKD.
本研究旨在通过使用全国住院患者样本(NIS)数据进行基于人群的回顾性分析,调查慢性肾脏疾病(CKD)与不同胃部疾病之间的关系。共纳入7159694名被诊断为伴有或不伴有CKD的胃部疾病的患者,胃炎、胃息肉、消化性溃疡病(PUD)和幽门螺杆菌感染的诊断基于ICD-10-CM代码。研究发现,与非CKD患者相比,CKD患者的胃炎和胃息肉患病率更高,尤其是在CKD晚期。调整后,CKD患者患这些胃部疾病的风险也高于非CKD患者。然而,CKD的所有阶段与PUD或幽门螺杆菌感染之间没有显著关联。这些结果强调了监测CKD患者胃健康的重要性。
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引用次数: 0
Metoclopramide in Gastroparesis: Its Mechanism of Action and Safety Profile 胃复安治疗胃轻瘫的作用机制及安全性
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-08-01 DOI: 10.3390/gidisord5030026
M. Kalas, B. Trivedi, Mutaz Kalas, Luis Chavez, R. McCallum
Metoclopramide has been the cornerstone of gastroparesis management for the past 40 years as it is the only FDA-approved medication for gastroparesis. Other medications such as erythromycin and domperidone have been used off-label with variable efficacy. Historically, metoclopramide has been used in oral, intravenous, and subcutaneous formulations. It is an antiemetic and prokinetic medication that acts through the inhibition of central (chemoreceptor trigger zone) and peripheral dopaminergic and serotogenic receptors. Due to its antidopaminergic effects, extrapyramidal symptoms have been reported, with the most feared adverse event being tardive dyskinesia. Subsequently, the FDA issued a metoclopramide black box warning label in February 2009 due to its risk of causing tardive dyskinesia, which can be irreversible. The incidence and prevalence of tardive dyskinesia among metoclopramide users have been variable in different studies. However, upon review of the current literature, the true prevalence of tardive dyskinesia seems to be lower than previously thought. This review will focus on metoclopramide and the extrapyramidal symptoms associated with its use.
在过去的40年里,甲氧氯普胺一直是胃轻瘫治疗的基石,因为它是fda批准的唯一治疗胃轻瘫的药物。其他药物,如红霉素和多潘立酮,已在说明书外使用,疗效不一。历史上,甲氧氯普胺已用于口服、静脉注射和皮下制剂。它是一种止吐和促运动药物,通过抑制中枢(化学受体触发区)和外周多巴胺能和血清生成受体起作用。由于其抗多巴胺能作用,锥体外系症状已被报道,最可怕的不良事件是迟发性运动障碍。随后,FDA于2009年2月发布了甲氧氯普胺黑盒警告标签,因为它有导致迟发性运动障碍的风险,这可能是不可逆的。在不同的研究中,甲氧氯普胺使用者迟发性运动障碍的发生率和流行率各不相同。然而,回顾目前的文献,迟发性运动障碍的真正患病率似乎比以前认为的要低。本综述将重点关注甲氧氯普胺及其使用相关的锥体外系症状。
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引用次数: 0
期刊
Gastrointestinal disorders (Basel, Switzerland)
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