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Comprehensive Review of Acute Pancreatitis Pain Syndrome 急性胰腺炎疼痛综合征的综合综述
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-04-10 DOI: 10.3390/gidisord5020014
Jake Beiriger, Adnan Khan, Binghai Yan, Heather Ross, Makala Wang, Michael Carducci, N. Parra, Salil Chowdhury, Ryan Erwin, Paul Forrest, Sarah L. Chen, Alexis Gerber
Pancreatitis is a condition that causes inflammation in the pancreas, an organ located behind the stomach. This condition often presents as neuropathic, inflammatory, and/or visceral pain. Acute pancreatitis is typically characterized by sudden and severe abdominal pain, often in the upper right part of the abdomen. The pain from pancreatitis can be caused by different mechanisms, such as abnormal activation of pancreatic zymogens or NF-κB mediated inflammation in the pancreas. The treatment of pancreatitis depends on its type, severity, and underlying cause. Hospitalization and medications are typically necessary, while in others, surgery may be required. Proper management of pancreatitis is essential, as it can help reduce the risk of complications and improve the patient’s quality of life. The literature on pancreatitis pain management evaluates systematic approaches and the effectiveness of various treatments, such as lidocaine, opioid agonists, ketamine, magnesium, endoscopic methods, spinal cord stimulation, and other novel treatments present opportunities for exploration in pancreatitis pain management.
胰腺炎是一种引起胰腺炎症的疾病,胰腺是位于胃后面的器官。这种情况通常表现为神经性、炎症性和/或内脏疼痛。急性胰腺炎的典型特征是突然和剧烈的腹痛,通常发生在腹部的右上部分。胰腺炎引起的疼痛可由不同的机制引起,如胰腺酶原异常激活或NF-κB介导的胰腺炎症。胰腺炎的治疗取决于其类型、严重程度和潜在原因。住院治疗和药物治疗通常是必要的,而在其他情况下,可能需要手术。胰腺炎的适当管理是必不可少的,因为它可以帮助减少并发症的风险,提高患者的生活质量。关于胰腺炎疼痛管理的文献评估了系统的方法和各种治疗的有效性,如利多卡因、阿片类激动剂、氯胺酮、镁、内窥镜方法、脊髓刺激和其他新的治疗方法,为胰腺炎疼痛管理的探索提供了机会。
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引用次数: 0
Crosstalk between Gut Microbiota and Hepatocellular Carcinoma 肠道菌群与肝细胞癌之间的串扰
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-04-04 DOI: 10.3390/gidisord5020013
Chencheng Xie, C. Pocha
In recent decades, gut microbiota have received emerging attention regarding their integral role in chronic liver disease progression, given the anatomic connection and the gut–liver axis. Emerging evidence has indicated a complex link between gut microbiota and hepatocellular carcinoma. This review explores the pathophysiological crosstalk between gut dysbiosis and hepatocarcinogenesis. The metabolic and immunologic effects mediated by gut-microbiota-derived metabolites, such as bile acids, short-chain fatty acids, and alcohol, could impact the aberrant biological behavior of hepatocellular carcinoma. This review also investigates the value of gut microbiota as novel non-invasive diagnostic biomarkers for the early detection of hepatocellular carcinoma, and summarizes the changes in the gut microbiota spectrum in patients with liver cancer. The current literature and studies on the role of the gut microbiota as adjuvant agents in liver cancer immunotherapy are reviewed.
近几十年来,鉴于解剖联系和肠肝轴,肠道微生物群在慢性肝病进展中的整体作用越来越受到关注。新出现的证据表明,肠道微生物群与肝细胞癌之间存在复杂的联系。这篇综述探讨了肠道微生态失调和肝癌发生之间的病理生理串扰。肠道微生物群衍生代谢产物(如胆汁酸、短链脂肪酸和酒精)介导的代谢和免疫作用可能影响肝细胞癌的异常生物学行为。本综述还研究了肠道微生物群作为新的非侵入性诊断生物标志物在肝癌早期检测中的价值,并总结了癌症患者肠道微生物群谱的变化。综述了肠道微生物群作为佐剂在癌症免疫治疗中的作用的最新文献和研究。
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引用次数: 1
Evaluation of Structured, Semi-Structured, and Free-Text Electronic Health Record Data to Classify Hepatitis C Virus (HCV) Infection 结构化、半结构化和自由文本电子健康记录数据对丙型肝炎病毒(HCV)感染分类的评估
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-03-31 DOI: 10.3390/gidisord5020012
A. Fong, Justin M. Hughes, Sravya Gundapenini, Benjamin Hack, Mahdi Barkhordar, S. Huang, Adam J. Visconti, Stephen J Fernandez, D. Fishbein
Evaluation of the United States Centers for Disease Control and Prevention (CDC)-defined HCV-related risk factors are not consistently performed as part of routine care, rendering risk-based testing susceptible to clinician bias and missed diagnoses. This work uses natural language processing (NLP) and machine learning to identify patients who are at high risk for HCV infection. Models were developed and validated to predict patients with newly identified HCV infection (detectable RNA or reported HCV diagnosis). We evaluated models with three types of variables: structured (structured-based model), semi-structured and free-text notes (text-based model), and all variables (full-set model). We applied each model to three stratifications of data: patients with no history of HCV prior to 2020, patients with a history of HCV prior to 2020, and all patients. We used XGBoost and ten-fold C-statistic cross-validation to evaluate the generalizability of the models. There were 3564 unique patients, 487 with HCV infection. The average C-statistics on the structured-based, text-based, and full-set models for all the patients were 0.777 (95% CI: 0.744–0.810), 0.677 (95% CI: 0.631–0.723), and 0.774 (95% CI: 0.735–0.813), respectively. The full-set model performed slightly better than the structured-based model and similar to text-based models for patients with no history of HCV prior to 2020; average C-statistics of 0.780, 0.774, and 0.759, respectively. NLP was able to identify six more risk factors inconsistently coded in structured elements: incarceration, needlestick, substance use or abuse, sexually transmitted infections, piercings, and tattoos. The availability of model options (structured-based or text-based models) with a similar performance can provide deployment flexibility in situations where data is limited.
美国疾病控制与预防中心(CDC)定义的HCV相关风险因素的评估并没有作为常规护理的一部分持续进行,这使得基于风险的检测容易受到临床医生偏见和漏诊的影响。这项工作使用自然语言处理(NLP)和机器学习来识别HCV感染的高危患者。开发并验证了模型,以预测新发现的HCV感染患者(可检测的RNA或报告的HCV诊断)。我们评估了具有三种类型变量的模型:结构化(基于结构化的模型)、半结构化和自由文本注释(基于文本的模型)以及所有变量(全套模型)。我们将每个模型应用于三个数据分层:2020年之前没有丙型肝炎病史的患者、2020年之前有丙型肝炎史的患者和所有患者。我们使用XGBoost和十倍C统计交叉验证来评估模型的可推广性。共有3564名独特的患者,其中487人感染了丙型肝炎病毒。所有患者基于结构化、基于文本和全套模型的平均C统计量分别为0.777(95%CI:0.744-0.810)、0.677(95%CI=0.631-0.723)和0.774(95%CI:0.735-0.813)。对于2020年之前没有HCV病史的患者,全套模型的表现略好于基于结构化的模型,类似于基于文本的模型;平均C统计量分别为0.780、0.774和0.759。NLP能够识别出另外六个结构元素编码不一致的风险因素:监禁、针刺、药物使用或滥用、性传播感染、穿孔和纹身。具有类似性能的模型选项(基于结构化或基于文本的模型)的可用性可以在数据有限的情况下提供部署灵活性。
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引用次数: 0
How the Gut Microbiome Is Altered in COVID-19 新冠肺炎肠道微生物组的变化
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-03-20 DOI: 10.3390/gidisord5010011
G. Merra
Microbioma and Viral Infections Respiratory infections are some of the main causes of hospitalization and mortality in older patients, especially [...]
微生物瘤和病毒感染呼吸道感染是老年患者住院和死亡的一些主要原因,特别是[…]
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引用次数: 0
Scoping Review of Acupuncture and Moxibustion in the Treatment of Inflammatory Bowel Disease 针灸治疗炎症性肠病的范围综述
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-03-03 DOI: 10.3390/gidisord5010010
A. Farrukh, J. Mayberry
Acupuncture and moxibustion are complementary therapies used by a significant number of patients with inflammatory bowel disease. There is limited research evidence of their effectiveness in the management of ulcerative colitis and, albeit less limited, in the case of Crohn’s disease. However, due to a lack of knowledge, their use as additional supportive therapy by gastroenterologists and specialist nurses is uncommon. Current evidence would indicate that they have a place as additional supportive treatments for patients with inflammatory bowel disease and their efficacy should be assessed through appropriately powered trials. In days of shared care and responsibilities between patients and clinicians, there is a need to share such information with patients so that they can make informed decisions.
针灸是大量炎症性肠病患者使用的补充疗法。关于它们在溃疡性结肠炎治疗中的有效性,研究证据有限,尽管不太有限,但在克罗恩病的治疗中也是如此。然而,由于缺乏知识,胃肠病学家和专科护士很少将其用作额外的支持性治疗。目前的证据表明,它们可以作为炎症性肠病患者的额外支持性治疗方法,其疗效应通过适当的试验进行评估。在患者和临床医生共享护理和责任的时代,有必要与患者共享这些信息,以便他们能够做出明智的决定。
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引用次数: 0
Cognitive Impairment in Celiac Disease Patients: Scoping Review Exploring Psychological Triggers in a Chronic Condition 腹腔疾病患者的认知障碍:探讨慢性疾病心理触发因素的范围综述
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-03-01 DOI: 10.3390/gidisord5010009
Alberto Caruso, D. Di Giacomo
Celiac disease (CD), also known as gluten-sensitive enteropathy, is an inflammatory autoimmune reaction triggered by ingestion of gluten in genetically predisposed subjects. Celiac disease is often associated with a wide range of disorders, caused by immune responses and by malabsorption with subsequent nutritional deficiencies. Prevalent neurologic manifestations are ataxia, epilepsy, cerebral calcification, cerebral white matter lesions, peripheral neuropathy and myopathy, but also cognitive impairment. The study aimed to identify emerging and urgent research domains in order to establish a CD-specific patient-tailored protocol that includes both psychological and neuropsychological evaluations. We performed a systematic search of MEDLINE, PubMed, SCOPUS, Web of Science and Cochrane library in November 2022. We conducted a descriptive analysis of the characteristics of the included literature. Based on the exclusion/inclusion criteria, a total of seven articles were included in the scoping review process. This review demonstrated the lack of research on CD-related cognitive impairment key features and tries to focus on both cognitive and psychological manifestations as well as their two-way interaction. We tried to establish the specific areas involved, in order to have a comprehensive view of this condition and trying to determine a correct way of assessing CD cognitive impairment and its correlations with psychological distress and personal coping skills to a chronic condition. Nevertheless, research on this topic is progressively increasing and future studies should address specific key points.
乳糜泻(CD),也被称为麸质敏感性肠病,是一种由摄入麸质引发的炎症性自身免疫反应。乳糜泻通常与多种疾病相关,由免疫反应和吸收不良引起,随后伴有营养缺乏。常见的神经系统表现为共济失调、癫痫、脑钙化、脑白质病变、周围神经病变和肌病,但也有认知障碍。该研究旨在确定新兴和紧迫的研究领域,以建立一个特定的cd患者定制方案,包括心理和神经心理学评估。我们于2022年11月对MEDLINE、PubMed、SCOPUS、Web of Science和Cochrane图书馆进行了系统检索。我们对纳入文献的特征进行了描述性分析。根据排除/纳入标准,共有7篇文章被纳入范围审查过程。本文综述了cd相关认知障碍主要特征研究的不足,并试图关注认知和心理表现及其双向互动。我们试图建立涉及的具体领域,以便对这种情况有一个全面的看法,并试图确定一种正确的方法来评估CD认知障碍及其与心理困扰和个人应对慢性疾病的技能的相关性。然而,关于这一主题的研究正在逐步增加,未来的研究应该解决具体的关键点。
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引用次数: 0
Evaluation and Management of Pediatric Feeding Disorder 小儿进食障碍的评估与治疗
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-02-16 DOI: 10.3390/gidisord5010008
Rajmohan Dharmaraj, Rasha A Elmaoued, Razan H. Alkhouri, P. Vohra, R. Castillo
Feeding disorders are increasingly common in children, especially as medical advancements improve the life expectancy of children born with prematurity and complex medical conditions. The most common symptoms include malnutrition, refusal to eat and drink, food pocketing, disruptive feeding behavior, slow feeding, food selectivity or rigid food preferences, limited appetite, and delayed feeding milestones. A unifying diagnostic definition of pediatric feeding disorder has been proposed by a panel of experts to improve the quality of health care and advance research. Referral to specialized care should be considered when feeding problems are complex or difficult to resolve. In this review, we provide an overview of the evaluation and management of pediatric feeding disorders and information that may be useful when considering whether referral to specialized care may be beneficial.
喂养障碍在儿童中越来越普遍,特别是随着医学进步提高了出生时患有早产和复杂疾病的儿童的预期寿命。最常见的症状包括营养不良、拒绝进食和饮水、食物口袋、破坏性喂养行为、喂养缓慢、食物选择性或严格的食物偏好、食欲有限和喂养里程碑延迟。一个专家小组提出了儿科喂养障碍的统一诊断定义,以提高卫生保健质量和推进研究。当喂养问题复杂或难以解决时,应考虑转诊到专门护理机构。在这篇综述中,我们概述了儿科喂养障碍的评估和管理,以及在考虑转诊到专科护理是否有益时可能有用的信息。
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引用次数: 4
Percutaneous Biliary Rendez-Vous to Treat Complete Hepatic-Jejunal Anastomosis Dehiscence after Duodeno-Cephalo-Pancreasectomy 经皮胆道融合治疗十二指肠-头-胰切除术后肝-空肠吻合完全破裂
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-02-06 DOI: 10.3390/gidisord5010007
F. Andresciani, G. Pacella, E. Faiella, Andrea Buoso, C. Altomare, R. Grasso
Hepaticojejunostomy is an essential component of many surgical procedures, including pancreaticoduodenectomy. Biliary leaks after HJS represent a major complication leading to relevant clinical problems: the postoperative mortality rate could reach 70% for surgical re-intervention, whereas endoscopic management is technically difficult due to the postoperative anatomy. Interventional Radiology plays a pivotal role for these patients. The case of a percutaneous biliary rendez-vous procedure performed to treat an HJA dehiscence after duodeno-cephalo-pancreasectomy is presented, which is successfully guaranteed to avoid a new surgical approach.
肝十二指肠造口术是包括胰十二指肠切除术在内的许多外科手术的重要组成部分。HJS术后胆道渗漏是导致相关临床问题的主要并发症:手术再干预的术后死亡率可能达到70%,而内镜治疗由于术后解剖结构的原因在技术上很困难。介入放射学对这些患者起着关键作用。介绍了一例经皮胆道减压手术治疗十二指肠-头胰腺切除术后HJA裂开的病例,该手术成功地避免了一种新的手术方法。
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引用次数: 0
Gastrointestinal Involvement in Primary Antibody Deficiencies 一抗缺乏对胃肠道的影响
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-01-29 DOI: 10.3390/gidisord5010006
Tomáš Milota, J. Smetanova, I. Klojdová
Primary antibody deficiencies (PADs) are the most frequent group of inborn errors of immunity. Impaired B-cell development, reduced production of immunoglobulins (mainly IgG and IgA), and specific antibodies resulting in recurrent infections are their hallmarks. Infections typically affect the respiratory tract; however, gastrointestinal involvement is also common. These include infection with Helicobacter pylori, Salmonella, Campylobacter species, Giardia, and noroviruses. Impaired IgA production also contributes to dysbiosis and thereby an increase in abundance of species with proinflammatory properties, resulting in immune system dysregulation. Dysregulation of the immune system results in a broad spectrum of non-infectious manifestations, including autoimmune, lymphoproliferative, and granulomatous complications. Additionally, it increases the risk of malignancy, which may be present in more than half of patients with PADs. Higher prevalence is often seen in monogenic causes, and gastrointestinal involvement may clinically mimic various conditions including inflammatory bowel diseases and celiac disease but possess different immunological features and response to standard treatment, which make diagnosis and therapy challenging. The spectrum of malignancies includes gastric cancer and lymphoma. Thus, non-infectious manifestations significantly affect mortality and morbidity. In this overview, we provide a comprehensive insight into the epidemiology, genetic background, pathophysiology, and clinical manifestations of infectious and non-infectious complications.
一抗缺陷(PADs)是最常见的先天性免疫缺陷。b细胞发育受损,免疫球蛋白(主要是IgG和IgA)产生减少,以及导致复发性感染的特异性抗体是其特征。感染通常影响呼吸道;然而,累及胃肠道也很常见。这些感染包括幽门螺杆菌、沙门氏菌、弯曲杆菌、贾第鞭毛虫和诺如病毒。受损的IgA生产也有助于生态失调,从而增加具有促炎特性的物种的丰度,导致免疫系统失调。免疫系统失调导致广泛的非感染性表现,包括自身免疫、淋巴增生性和肉芽肿并发症。此外,它增加了恶性肿瘤的风险,超过一半的pad患者可能存在恶性肿瘤。在单基因病因中患病率较高,胃肠道受累可能在临床上模拟各种疾病,包括炎症性肠病和乳糜泻,但具有不同的免疫特征和对标准治疗的反应,这使得诊断和治疗具有挑战性。恶性肿瘤包括胃癌和淋巴瘤。因此,非传染性表现显著影响死亡率和发病率。在本综述中,我们提供了一个全面的洞察流行病学,遗传背景,病理生理,和临床表现的传染性和非传染性并发症。
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引用次数: 0
Acknowledgment to the Reviewers of Gastrointestinal Disorders in 2022 感谢胃肠疾病审稿人在2022年
Q4 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-01-28 DOI: 10.3390/gidisord5010005
High-quality academic publishing is built on rigorous peer review [...]
高质量的学术出版建立在严格的同行评审的基础上[…]
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引用次数: 0
期刊
Gastrointestinal disorders (Basel, Switzerland)
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