|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Anemia in inflammatory bowel disease: A neglected issue with relevant effects显示文摘Anemia,a common complication associated with inflammatory bowel disease(IBD),is frequently overlooked in the management of IBD patients.Unfortunately,it represents one of the major causes of both decreased quality of life and increased hospital admissions among this population.Anemia in IBD is pathogenically complex,with several factors contributing to its development.While iron deficiency is the most common cause,vitamin B12and folic acid deficiencies,along with the effects of pro-inflammatory cytokines,hemolysis,drug therapies,and myelosuppression,have also been identified as the underlying etiology in a number of patients.Each of these etiological factors thus needs to be identified and corrected in order to effectively manage anemia in IBD.Because the diagnosis of anemia in IBD often presents a challenge,combinations of several hematimetric and biochemical parameters should be used.Recent studies underscore the importance of determining the ferritin index and hepcidin levels in order to distinguish between iron deficiency anemia,anemia due to chronic disease,or mixed anemia in IBD patients.With regard to treatment,the newly introduced intravenous iron formulations have several advantages over orally-administerediron compounds in treating iron deficiency in IBD.In special situations,erythropoietin supplementation and biological therapies should be considered.In conclusion,the management of anemia is a complex aspect of treating IBD patients,one that significantly influences the prognosis of the disease.As a consequence,its correction should be considered a specific,first-line therapeutic goal in the management of these patients. | Danila Guagnozzi Alfredo J Lucendo | 2014 | World Journal of Gastroenterology2014，20，13： | 12 |
| 2 | 肝的 osteodystrophy : 为在长期的肝的考虑的一件重要的事疾病显示文摘 Hepatic osteodystrophy (HO) is the generic term defining the group of alterations in bone mineral metabolism found in patients with chronic liver disease. This paper is a global review of HO and its main pathophysiological, epidemiological and therapeutic aspects. Studies examining the most relevant information concerning the prevalence, etiological factors, diagnostic and therapeutic aspects involved in HO were identified by a systematic literature search of the PubMed database. HO generically defines overall alterations in bone mineral density (BMD) (osteoporosis or osteopenia) which appear as a possible complication of chronic liver disease. The origin of HO is multifactorial and its etiology and severity vary in accordance with the underlying liver disease. Its exact prevalence is unknown, but different studies estimate that it could affect from 20% to 50% of patients. The reported mean prevalence of osteoporosis ranges from 13%-60% in chronic cholestasis to 20% in chronic viral hepatitis and 55% in viral cirrhosis. Alcoholic liver disease is not always related to osteo-penia. HO has been commonly studied in chronic cholestatic disease (primary biliary cirrhosis and primary sclerosing cholangitis). Several risk factors and pathogenic mechanisms have been associated with the loss of BMD in patients with chronic liver disease. However, little information has been discovered in relationship to most of these mechanisms. Screening for osteopenia and osteoporosis is recommended in advanced chronic liver disease. There is a lack of randomized studies assessing specific management for HO. | Germán López-Larramona Alfredo J Lucendo Sonia González-Castillo José M Tenias | 2011 | World Journal of Hepatology2011，3，12： | 9 |
| 3 | Colorectal cancer surveillance in patients with inflammatory bowel disease: What's new?显示文摘Several studies assessing the incidence of colorectal cancer (CRC) in inflammatory bowel disease (IBD) patients have found an increased risk globally estimated to be 2 to 5 times higher than for the general population of the same age group. The real magnitude of this risk, however, is still open to debate. Research is currently being carried out on several risk and protective factors for CRC that have recently been identified in IBD patients. A deeper understanding of these factors could help stratify patient risk and aid specialists in choosing which surveillance program is most efficient. There are several guidelines for choosing the correct surveillance program for IBD patients; many present common characteristics with various distinctions. Current recommendations are far from perfect and have important limitations such as the fact that their efficiency has not been demonstrated through randomized controlled trials, the limited number of biopsies performed in daily endoscopic practice, and the difficulty in establishing the correct time to begin a given surveillance program and maintain a schedule of surveillance. That being said, new endoscopic technologies should help by replacing random biopsy protocols with targeted biopsies in IBD patients, thereby improving the efficiency of surveillance programs.However, further studies are needed to evaluate the cost-effectiveness of introducing these techniques into daily endoscopic practice. | Danila Guagnozzi Alfredo J Lucendo | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，4： | 6 |
| 4 | Small bowel video capsule endoscopy in Crohn’s disease: What have we learned in the last ten years?显示文摘Since its introduction in 2001, capsule endoscopy (CE) has become the most important advance in the study of small bowel disease, including Crohn's disease (CD). This technique has been demonstrated to be superior to all other current forms of radiological investigation in detecting mucosal abnormalities of small bowel nonstricturing CD. CE has proven to be extremely useful in diagnosing CD in patients with inconclusive findings from ileocolonoscopy and x-ray-based studies. Almost half of all patients with CD involving the ileum also present lesions in proximal intestinal segments, with the small bowel being exclusively involved in up to 30% of all CD cases. Despite the widespread use of CE, several questions concerning the utility of this technique remain unanswered. The lack of commonly agreed diagnostic criteria for defining CD lesions with the aid of CE may have had an influence on the variation in diagnostic re sults for CE reported in the literature. The utility of CE in monitoring CD and in guiding therapy has also been proposed. Furthermore, CE could be a useful second-line technique for patients with an established diagn osis of CD and unexplained symptoms. Finally, as no thres hold for CD diagnosis has been agreed upon, a se verity scale of mucosal disease activity has notbeen universally followed. None of the available activity indexes based on CE findings has been independently validated. This article discusses several cutting-edge aspects of the usefulness of CE in CD 10 years after its introduction as a sensible method to study the small intestine. | Alfredo J Lucendo Danila Guagnozzi | 2011 | World Journal of Gastrointestinal Endoscopy2011，3，2： | 4 |
| 5 | Resolution of metabolic syndrome after following a gluten free diet in an adult woman diagnosed with celiac disease显示文摘Adult celiac disease(CD) presents with very diverse symptoms that are clearly different from those typically seen in pediatric patients,including ferropenic anemia,dyspepsia,endocrine alterations and elevated transaminase concentration. We present the case of a 51-year-old overweight woman with altered basal blood glucose,hypercholesterolemia,hypertriglyceridemia and persisting elevated transaminase levels,who showed all the symptoms for a diagnosis of metabolic syndrome. Because she presented iron deficiency anemia,she was referred to the gastroenterology department and subsequently diagnosed with celiac disease after duodenal biopsies and detection of a compatible HLA haplotype. Gluten-free diet(GFD) was prescribed and after 6 mo the patient showed resolution of laboratory abnormalities(including recovering anemia and iron reserves,normalization of altered lipid and liver function parameters and decrease of glucose blood levels) . No changes in weight or waist circumference were observedand no significant changes in diet were documented apart from the GFD. The present case study is the first reported description of an association between CD and metabolic syndrome,and invites investigation of the metabolic changes induced by gluten in celiac patients. | lvaro García-Manzanares Alfredo J Lucendo Sonia González-Castillo Jesús Moreno-Fernández | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，3： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员