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1.
World J Gastroenterol ; 28(18): 1875-1901, 2022 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-35664966

RESUMO

Gut microbiota has a significant role in gut development, maturation, and immune system differentiation. It exerts considerable effects on the child's physical and mental development. The gut microbiota composition and structure depend on many host and microbial factors. The host factors include age, genetic pool, general health, dietary factors, medication use, the intestine's pH, peristalsis, and transit time, mucus secretions, mucous immunoglobulin, and tissue oxidation-reduction potentials. The microbial factors include nutrient availability, bacterial cooperation or antagonism, and bacterial adhesion. Each part of the gut has its microbiota due to its specific characteristics. The gut microbiota interacts with different body parts, affecting the pathogenesis of many local and systemic diseases. Dysbiosis is a common finding in many childhood disorders such as autism, failure to thrive, nutritional disorders, coeliac disease, Necrotizing Enterocolitis, helicobacter pylori infection, functional gastrointestinal disorders of childhood, inflammatory bowel diseases, and many other gastrointestinal disorders. Dysbiosis is also observed in allergic conditions like atopic dermatitis, allergic rhinitis, and asthma. Dysbiosis can also impact the development and the progression of immune disorders and cardiac disorders, including heart failure. Probiotic supplements could provide some help in managing these disorders. However, we are still in need of more studies. In this narrative review, we will shed some light on the role of microbiota in the development and management of common childhood disorders.


Assuntos
Gastroenteropatias , Microbioma Gastrointestinal , Infecções por Helicobacter , Helicobacter pylori , Microbiota , Criança , Disbiose/microbiologia , Gastroenteropatias/terapia , Humanos , Recém-Nascido
2.
World J Gastroenterol ; 28(20): 2152-2162, 2022 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-35721881

RESUMO

Given the breakthroughs in key technologies, such as image recognition, deep learning and neural networks, artificial intelligence (AI) continues to be increasingly developed, leading to closer and deeper integration with an increasingly data-, knowledge- and brain labor-intensive medical industry. As society continues to advance and individuals become more aware of their health needs, the problems associated with the aging of the population are receiving increasing attention, and there is an urgent demand for improving medical technology, prolonging human life and enhancing health. Digestive system diseases are the most common clinical diseases and are characterized by complex clinical manifestations and a general lack of obvious symptoms in the early stage. Such diseases are very difficult to diagnose and treat. In recent years, the incidence of diseases of the digestive system has increased. As AI applications in the field of health care continue to be developed, AI has begun playing an important role in the diagnosis and treatment of diseases of the digestive system. In this paper, the application of AI in assisted diagnosis and the application and prospects of AI in malignant and benign digestive system diseases are reviewed.


Assuntos
Aprendizado Profundo , Gastroenteropatias , Inteligência Artificial , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Humanos , Redes Neurais de Computação
4.
Dtsch Med Wochenschr ; 147(10): 595-604, 2022 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-35545068

RESUMO

Approximately 50 % of chronic gastrointestinal symptoms in primary care can be attributed to functional gastrointestinal disorders (FGID). The most frequent gastrointestinal disorders are functional dyspepsia and irritable bowel syndrome. FGID are heterogenous with regards to the amount of symptoms and associated patient's impairment as well as to the underlying pathophysiological mechanisms. The biopsychosocial model of FGID assumes that biological, psychological and social factors interact in the predisposition to and in the initiation and course of FGID. The Rome Foundation defines FGID as disorders of the brain-gut interaction.Some physicians are hesitant to diagnose FGID due to the lack of specific biomarkers and/or structural changes in the gastrointestinal tract. In addition, some FGID to not respond well to conventional medications. Some patients are reluctant to accept the diagnosis of a FGID because they are afraid that a serious somatic disease has been missed and/or to be diagnosed as mentally ill.The use of interdisciplinary evidence-based guidelines for diagnosis and management of FGID can increase the certainty of diagnosis and the therapeutic options for physicians. In addition, these guidelines include recommendations how to explain the disorder and the management to the patient to establish a trustful doctor-patient relationship.FGID are diagnosed by the history of a typical cluster of symptoms and by guideline - recommended exclusion of somatic gastrointestinal disorders. FGID should be managed according to the main symptoms, the associated impairment and patients' preferences in a graduated approach by education and by dietary, pharmacological and psychological treatments.


Assuntos
Dispepsia , Gastroenteropatias , Síndrome do Intestino Irritável , Dispepsia/diagnóstico , Dispepsia/etiologia , Dispepsia/terapia , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/terapia , Relações Médico-Paciente
5.
Chin J Integr Med ; 28(6): 554-559, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35610498

RESUMO

Functional gastrointestinal disorders (FGIDs) are common disorders that are characterized by persistent and recurring gastrointestinal symptoms. Many patients with FGIDs have overlapping symptoms, which impaired the quality of life and ability to work of patients, and left a considerable impact on health-care systems and society. Chinese medicines (CMs) are commonly utilized by many patients with FGIDs. This article discusses the current status of diagnosis and treatment of FGIDs, the advantages and characteristics of CM treatment, and how integrated medicine can make a breakthrough in FGIDs diagnosis and treatment.


Assuntos
Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Medicina Integrativa , Medicina Tradicional do Leste Asiático , Pesquisa Biomédica , China , Humanos , Prevalência , Qualidade de Vida
6.
Dtsch Med Wochenschr ; 147(11): 696-704, 2022 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-35636421

RESUMO

The gastrointestinal tract is one of the most complex organ systems of the human body. On the one hand, it forms the absorption surface for nutrients, but on the other hand it is also a barrier for toxins, food components and against up to 1014 commensal microorganisms. The complexity of the interplay between absorption, motility and immune functions of the gastrointestinal tract is particularly evident in critically ill patients. In this article, we review the latest updates on pathogenic relationships of motility disorders and diagnostic algorithms in intensive care patients. In addition to established therapies, new developments in the treatment of hypomotility are outlined.


Assuntos
Estado Terminal , Gastroenteropatias , Estado Terminal/terapia , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Motilidade Gastrointestinal , Humanos
7.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 34(2): 113-120, 2022 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-35387714

RESUMO

Acute gastrointestinal dysfunction is a common and important complication of sepsis. As no exiting formal definition and classification of gastrointestinal dysfunction, most of the treatment strategies for gastrointestinal dysfunction are not based on clinical evidence, but on their own clinical experience. Experts of traditional Chinese medicine, integrated traditional Chinese and Western medicine and Western medicine from various disciplines in Shanghai are organized by the Shanghai Society of Integrated Traditional Chinese and Western Medicine and the Emergency Department Branch of Shanghai Physicians Association. After repeated discussion, literature search and formulation of the outline, we developed consensus on gastrointestinal dysfunction secondary to sepsis with integrating Traditional Chinese Medicine and Western medicine by consulting extensively on clinical experts in the fields of emergency medicine, gastroenterology, general surgery, infectious medicine and traditional Chinese medicine, and holding several expert forums and consultation meetings. This clinical expert consensus focused on acute gastrointestinal injury (AGI) classification and inducer of sepsis. In this consensus, the common symptoms, diagnosis, classifications, treatment strategies and suggestions of acute gastrointestinal injury or dysfunction secondary to sepsis were explored from the aspect of both Traditional Chinese Medicine and Western medicine.


Assuntos
Gastroenteropatias , Sepse , China , Consenso , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Medicina Tradicional Chinesa , Sepse/complicações , Sepse/terapia
8.
J Med Microbiol ; 71(4)2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35438624

RESUMO

Introduction. Autism spectrum disorder (ASD) is a neurodevelopmental disorder. The discovery of the influence of gut microbiota on mental illness opens up new research avenues for the role of gut microbiota modifiers, such as probiotics or prebiotics, as a potential course of treatment. Potential treatments have received considerable attention in recent years.Aim. The meta-analysis only included clinical controlled trials to explore whether probiotics and prebiotics can improve the overall severity of ASD symptoms in children, the severity of gastrointestinal (GI) problems and the comorbid psychopathlology in ASD.Gap statement. Although systematic reviews have been conducted in this area in the past, most of them are mixed experimental designs, and the reliability of the conclusions remains to be determined. To the best of our knowledge, no systematic review of randomized controlled trials (RCTs) has been conducted.Methodology. A meta analysis used a combination of subject terms and free words, or used keywords, titles, and abstracts to conduct in PubMed, Web of Science, Embase, and Cochrane Library to identify studies relevant to the current review.Result. The results of the meta-analysis showed that probiotics and prebiotics did not significantly improve the severity of ASD patients, GI problems and comorbid psychopathlology in ASD, and the result is contradictory to the previous literatures.Conclusion. Since there are relatively few clinical controlled trials that can be included, the results of this study still need to be further verified in the clinic. In the future, more randomized controlled studies, more research populations, and the use of more professional clinicians may provide more robust research results.


Assuntos
Transtorno do Espectro Autista , Gastroenteropatias , Microbioma Gastrointestinal , Probióticos , Transtorno do Espectro Autista/terapia , Criança , Gastroenteropatias/terapia , Humanos , Prebióticos , Probióticos/uso terapêutico
10.
Cleve Clin J Med ; 89(4): 200-211, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365558

RESUMO

Capsule endoscopy, also known as wireless capsule endoscopy or video capsule endoscopy, is a noninvasive procedure that uses a swallowed capsule-shaped miniature camera for direct visual and diagnostic evaluation of gastrointestinal (GI) disease. Although originally intended as a tool to examine the small intestine, which is mostly beyond the reach of conventional endoscopy, capsule endoscopy is now also being used to examine the entire length of the GI tract.


Assuntos
Endoscopia por Cápsula , Gastroenteropatias , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Humanos , Intestino Delgado/diagnóstico por imagem
14.
Artigo em Inglês | MEDLINE | ID: mdl-35331401

RESUMO

Several paediatric gastrointestinal diseases result in life-shortening organ failure. For many of these conditions, current therapeutic options are suboptimal and may not offer a cure. Regenerative medicine is an inter-disciplinary field involving biologists, engineers, and clinicians that aims to produce cell and tissue-based therapies to overcome organ failure. Exciting advances in stem cell biology, materials science, and bioengineering bring engineered gastrointestinal cell and tissue therapies to the verge of clinical trial. In this review, we summarise the requirements for bioengineered therapies, the possible sources of the various cellular and non-cellular components, and the progress towards clinical translation of oesophageal and intestinal tissue engineering to date.


Assuntos
Gastroenteropatias , Medicina Regenerativa , Bioengenharia , Criança , Gastroenteropatias/terapia , Pessoal de Saúde , Humanos , Engenharia Tecidual
16.
Lancet Gastroenterol Hepatol ; 7(5): 485-494, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35247318

RESUMO

GASTROSWOT is a strategic analysis of the current and projected states of the different subspecialties in gastroenterology that aims to provide guidance for research, clinical, and financial planning in gastroenterology. We executed a consensus-based international strengths, weaknesses, opportunities, and threats (SWOT) analysis. Four general coordinators, six field coordinators, and 12 experts participated in the study. SWOTs were provided for the following fields: neurogastroenterology, functional gastrointestinal disorders, and upper gastrointestinal diseases; inflammatory bowel disease; pancreatology and biliary diseases; endoscopy; gastrointestinal oncology; and hepatology. The GASTROSWOT analysis highlights the following in the current state of the field of gastroenterology: the incidence and complexity of several gastrointestinal diseases, including malignancies, are increasing; the COVID-19 pandemic has affected patient care on several levels; and with the advent of technical innovations in gastroenterology, a well trained workforce and strategic planning are required to optimise health-care utilisation. The analysis calls attention to the following in the future of gastroenterology: artificial intelligence and the use of big data will speed up discovery and smarter health-care provision in the field; the growth and diversification of gastroenterological specialties will improve specialised care for patients, but could promote fragmentation of care and health system inefficiencies; and furthermore, thoughtful planning is needed to reach an effective balance between the need for subspecialists and the value of general gastroenterology services.


Assuntos
COVID-19 , Gastroenterologia , Gastroenteropatias , Inteligência Artificial , Endoscopia Gastrointestinal , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Humanos , Pandemias
17.
J Gastrointestin Liver Dis ; 31(1): 98-106, 2022 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-35306547

RESUMO

BACKGROUND AND AIMS: Fabry disease (FD) is a rare chronic genetic disorder that presents under a paucity of symptoms. Gastrointestinal (GI) involvement is a common event and can sometimes be debilitating, but relatively often it is overlooked. We aimed to provide a systematic review of main GI symptoms in FD patients and treatment possibilities. METHODS: We completed a systematic review of literature, using the MeSH terms: "Fabry disease", "gastrointestinal", "gastrointestinal", "digestive", "manifestations", "symptoms", "clinical", "treatment", "therapy" and the supplementary concepts "enzyme replacement", "chaperone", "Migalastat", in different combinations, with defined inclusion and exclusion criteria. RESULTS: From 221 initial studies identified, through our selection process we included a final date base of 51 articles on GI signs and symptoms and their treatment. The primary GI manifestations of the disease consist of abdominal pain, bowel movement disorders or nausea and vomiting. Less frequent manifestations such as diverticular bowel disease, gastroesophageal reflux or achalasia have also been described. Main treatment options in FD are represented by enzyme replacement therapy and chaperone treatment. Patients presenting with GI symptoms unfortunately do not always respond to enzyme replacement, necessitating symptomatic relief. CONCLUSION: Fabry disease is a rare disease that often involves the GI tract, affecting patients' quality of life and burdening the healthcare system. Physicians must be aware of the multitude of manifestations in this category of patients, to promptly recognize and treat them.


Assuntos
Doença de Fabry , Gastroenteropatias , Terapia de Reposição de Enzimas , Doença de Fabry/complicações , Doença de Fabry/diagnóstico , Doença de Fabry/tratamento farmacológico , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Qualidade de Vida
18.
Adv Nutr ; 13(3): 846-856, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35266507

RESUMO

Kiwifruit have known positive effects on digestion. During clinical intervention trials using kiwifruit to improve constipation, upper gastrointestinal (GI) symptoms such as abdominal discomfort and pain, indigestion, and reflux were also alleviated. We aimed to evaluate the evidence for upper GI symptom relief by kiwifruit in clinical trials on participants with functional constipation (FC), irritable bowel syndrome with constipation (IBS-C), and healthy participants, and to elucidate which symptoms may be relieved and whether a difference exists between the effects of gold and green kiwifruit. We executed a systematic scoping review of 3 electronic databases from 1947 through January 2021 to identify clinical trials that reported effects of green or gold kiwifruit or kiwifruit compounds on upper GI symptoms as secondary outcomes in healthy participants or participants with FC or IBS-C. Studies were divided into those using the Gastrointestinal Symptom Rating Scale (GSRS) and those using alternative measurement tools. GSRS outcomes were pooled and statistically analyzed; non-GSRS outcomes were summarized. We identified 12 clinical trials with a total of 661 participants (124 controls, 537 receiving intervention) providing evidence for symptom relief of upper GI symptoms by kiwifruit intake. Only 5 of the 12 clinical trials used the GSRS to assess upper GI symptom relief. We found good evidence that green kiwifruit may reduce abdominal discomfort and pain, and some evidence that kiwifruit consumption may attenuate indigestion. Pooled GSRS outcome analysis indicates an average reduction of -0.85 (95% CI: -1.1, -0.57; Z = 6.1) in abdominal pain scores and -0.33 (95% CI: -0.52, -0.15; Z = -3.5) in indigestion scores with habitual kiwifruit consumption. While the number of studies reporting on upper GI symptom relief with a comparable measurement is limited, there is consistent evidence for the efficacy of kiwifruit on upper GI symptom relief. More research to strengthen the evidence is recommended.


Assuntos
Actinidia , Dispepsia , Gastroenteropatias , Síndrome do Intestino Irritável , Actinidia/química , Constipação Intestinal , Dispepsia/terapia , Gastroenteropatias/terapia , Humanos , Síndrome do Intestino Irritável/terapia , Dor/complicações
20.
Transpl Immunol ; 72: 101590, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35346826

RESUMO

BACKGROUND: Lung transplantation is the only effective way to treat end-stage lung disease. Severe gastrointestinal complications are common after lung transplantation and are associated with increased mortality. Early identification and active intervention are necessary to avoid treatment delays. Abdominal massage belongs to the category of external treatment of traditional Chinese medicine (TCM), which is often used in the treatment of internal diseases. It has an excellent effect in treating stomachache, bloating, anorexia, and constipation. CASE PRESENTATION: The patient developed gastrointestinal dysfunction 16 days after lung transplantation. Through the implementation of abdominal massage intervention, symptoms were significantly relieved, weight gain occurred, and the curative effect was good. CONCLUSION: Abdominal massage can relieve gastrointestinal symptoms and promote the recovery of gastrointestinal function after lung transplantation and has good curative effects. This method is worth promoting in patients who have had lung transplantation.


Assuntos
Gastroenteropatias , Transplante de Pulmão , Massagem , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Transplante de Pulmão/efeitos adversos
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