Abstract:
:Preeclampsia has traditionally been viewed as one of several forms of hypertension complicating pregnancy. More recently, the multisystem nature of this unique gestational disorder has been emphasized. Pathophysiologic events, including abnormal placentation and heightened vascular reactivity, may occur weeks or months prior to clinical recognition of the disease. Although most frequently presenting as hypertension and proteinuria, hepatic (abdominal pain and elevation of transaminases) and hematologic (intravascular hemolysis and thrombocytopenia) involvement may be important features of the disease. Current theories suggest that multiorgan dysfunction may be caused by widespread vascular endothelial dysfunction, vasospasm, and variable activation of coagulation mechanisms. Pending delivery, which is the only definitive therapy for preeclampsia, maternal complications of intracerebral hemorrhage and eclampsia may be prevented with judicious use of antihypertensive medication (e.g., hydralazine) and magnesium sulfate, respectively. Finally, data from a number of small trials suggest that low-dose aspirin (60-100 mg/d) may reduce the incidence of preeclampsia in patients at high risk without adversely affecting the fetus or newborn; however, it is recommended that aspirin not be used as a routine prophylactic intervention until publication of results of several ongoing large multicenter trials, which will help to more fully clarify the benefits and risks of this approach.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Barron WMsubject
Has Abstractpub_date
1992-12-01 00:00:00pages
851-72issue
4eissn
0889-8553issn
1558-1942journal_volume
21pub_type
杂志文章,评审abstract::Because there are no reliable biological or laboratory markers associated with the condition, the diagnosis of irritable bowel syndrome(IBS) is based on patient descriptions of common symptoms such as abdominal pain accompanied by changes in stool form or frequency and associated symptoms such as bloating and distensi...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2005.03.001
更新日期:2005-06-01 00:00:00
abstract::Evidence indicates that the gut microbiota and/or interactions between the microbiota and the host immune system are involved in the pathogenesis of inflammatory bowel disease (IBD). Strategies that target the microbiota have emerged as potential therapies and, of these, probiotics have gained the greatest attention. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.08.003
更新日期:2017-12-01 00:00:00
abstract::The application of EUS has improved the way we evaluate and manage patients with rectal cancer. EUS has substantially greater sensitivity than CT in detecting advanced T stage tumors. Such improved sensitivity results in changes in preoperative therapy that would not otherwise have occurred without EUS. Although the a...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(02)00050-x
更新日期:2002-12-01 00:00:00
abstract::A wide spectrum of gastrointestinal illnesses impairs bone health and can result in bone pain, demineralization, and fracture. This article summarizes current knowledge of the skeletal pathology exhibited in patients with diseases of the liver, biliary tree, pancreas, and bowel. Mechanisms responsible for these syndro...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70016-9
更新日期:1998-06-01 00:00:00
abstract::Esophageal high-resolution manometry (HRM) improves the management of patients with nonobstructive dysphagia. It has increased the diagnostic yield for detecting achalasia and defined three clinically relevant achalasia subtypes. Esophagogastric junction (EGJ) outflow obstruction, defined as an impaired EGJ relaxation...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2011.09.006
更新日期:2011-12-01 00:00:00
abstract::Although significant strides have been made in the surgical technique of orthotopic liver transplantation, numerous problems and nuisances are still encountered. Further surgical refinements will certainly evolve. The development of better preservation techniques, the use of intraoperative flowmeters, and the availabi...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract::The effort to improve outcomes in esophageal cancer has included attempts at improving staging and patient selection. 2-Deoxy-2-[(18)F]fluoro-Dglucose positron emission tomography (FDG-PET) has been extensively studied in this context and has been widely accepted as a staging tool. Its role in restaging or assessing t...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2009.01.007
更新日期:2009-03-01 00:00:00
abstract::Colorectal cancer (CRC) develops from a dysplastic precursor lesion, regardless of whether it arises sporadically, in the setting of high-risk hereditary conditions, or in the context of chronic inflammation like inflammatory bowel disease (IBD). This review focuses on the molecular alterations associated with CRC pat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2006.07.002
更新日期:2006-09-01 00:00:00
abstract::Diverticulitis represents a spectrum of clinical entities ranging from minimal pericolitis in the adjacent mesentery to uncontrolled intra-abdominal sepsis and septic shock. The presentation most often described is left lower quadrant abdominal pain, fever, chills, and left lower quadrant tenderness associated with a ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-06-01 00:00:00
abstract::Crohn's disease is not medically (and is rarely surgically) curable. Patients do, however, live a normal life span. The goal of therapy is to optimize the quality of life, minimize disease activity and disease-related complications, and avoid therapeutic toxicity. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(01)00011-5
更新日期:2002-03-01 00:00:00
abstract::Understanding of hemorrhoidal pathology and treatment has come a long way. The theory of a sliding anal canal lining and the knowledge that hemorrhoidal cushions are a normal part of the anal anatomy should encourage symptom control rather than radical removal of tissue. Techniques that fix the cushions back in positi...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70173-4
更新日期:2001-03-01 00:00:00
abstract::Although many mechanisms remain unclear, a large body of evidence indicates that several dietary and lifestyle factors are likely to have a major influence on the risk of colon cancer. Physical inactivity, excess body weight, and a central deposition of adiposity are consistent risk factors. Overconsumption of energy ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(02)00057-2
更新日期:2002-12-01 00:00:00
abstract::The modern management of patients with upper gastrointestinal bleeding includes, in selected patients, the performance of timely multimodal endoscopic hemostasis followed by profound acid suppression. This article discusses the available data on the use of antisecretory regimens in the management of patients with blee...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.08.002
更新日期:2010-09-01 00:00:00
abstract::Striking geographical differences occur in the clinical presentation of hepatocellular carcinoma in high and low incidence areas. This tumor is also associated with a number of paraneoplastic phenomena that may antedate the clinical appearance. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1987-12-01 00:00:00
abstract::A better definition of a pseudocyst that clearly separates it from acute fluid collection, improvements in imaging studies, and a better understanding of the natural history of pseudocysts have changed the concepts regarding their management. The old teaching that cysts of more than 6 cm in diameter that have been pre...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70077-7
更新日期:1999-09-01 00:00:00
abstract::It is shortsighted to consider only the esophageal manifestations and complications of esophageal reflux. That such reflux can directly affect not only the lung but also the oropharynx and larynx, both by direct acid contact and reflex neurologic mechanisms, has been demonstrated repeatedly. The task of the future wil...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-09-01 00:00:00
abstract::Barium radiography of the gastrointestinal tract in patients with AIDS can assist in the evaluation of numerous problems including dysphagia, odynophagia, diarrhea, abdominal pain, symptoms of intermittent obstruction, and/or gastrointestinal bleeding. It can localize disease, evaluate complications, guide endoscopic ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-09-01 00:00:00
abstract::Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as prima...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2019.08.005
更新日期:2019-12-01 00:00:00
abstract::Colorectal cancer is a major illness in the Western world. International and migrant studies suggest that environmental causes, notably a fat- and calorie-dense diet (even if adopted in adulthood), are associated with the disease. Case-control studies have not conclusively identified specific etiologic dietary factors...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-12-01 00:00:00
abstract::Focal liver lesions occur commonly and with varying histology, each requiring radically different management. There are a multitude of imaging modalities currently being used for detecting and characterizing focal liver neoplasms. The primary modalities include ultrasonography, computed tomography (CT), magnetic reson...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(02)00028-6
更新日期:2002-09-01 00:00:00
abstract::Ischemic injury to the gastrointestinal tract can threaten bowel viability with potential catastrophic consequences, including intestinal necrosis and gangrene. The presenting symptoms and signs are relatively nonspecific and diagnosis requires a high index of clinical suspicion. AMI often results from an embolus or t...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(03)00093-1
更新日期:2003-12-01 00:00:00
abstract::BA is a rare disease of unclear etiology; nevertheless, its impact in the field of pediatric hepatology is significant. It is the most common surgically correctable cause of neonatal cholestasis and is the most common pediatric disease referred for liver transplantation. Little progress has been made with regard to im...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(03)00049-9
更新日期:2003-09-01 00:00:00
abstract::Corticosteroids are of proven value for the treatment of active ulcerative colitis and Crohn's disease, but are of little value for the maintenance of remission. The development of new steroid compounds with low systemic bioavailability should allow higher doses to be given for longer periods without risking serious a...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::Nutritional support can improve the outcome from severe acute pancreatitis in two ways: first by providing the building blocks for tissue repair and recovery, and second, by modulating the inflammatory response and preventing organ failure, both of which are responsible for most of the morbidity and mortality associat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.03.009
更新日期:2007-06-01 00:00:00
abstract::Individuals with a genetic predisposition to Crohn's disease develop aberrant immune responses to environmental triggers. The gastrointestinal microbiota is increasingly recognized to play an important role in the development of Crohn's disease. Decrease in global gut microbial diversity and specific bacterial alterat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.05.004
更新日期:2017-09-01 00:00:00
abstract::Inborn errors of metabolism (IEMs) are usually recognized by characteristic neurologic and metabolic manifestations and sometimes by dysmorphism. However, IEMs can present with a wide variety of gastrointestinal manifestations, whether as the primary or a minor clinical symptom. Regardless, gastrointestinal and hepati...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2019.02.001
更新日期:2019-06-01 00:00:00
abstract::The development of colorectal neoplasia originates from normal colonic mucosa, progresses to the adenomatous polyp, and later may evolve into carcinoma. This procession of histologic change can be defined by a series of successive waves of clonal expansion that contain certain genetic alterations. These genetic altera...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70272-7
更新日期:1996-12-01 00:00:00
abstract::The use of high-frequency ultrasound transducers combined with manometry in the gastrointestinal (GI) tract has yielded important findings concerning the anatomy, physiology, and pathophysiology of the high-pressure zone of the gastroesophageal junction and the sphincteric muscles within. These transducers have made p...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.07.008
更新日期:2007-09-01 00:00:00
abstract::Ulcerative colitis and Crohn's disease both may occur in the elderly. In many populations, a second peak in the incidence of inflammatory bowel disease occurs near age 70. Clinical manifestations of inflammatory bowel disease in the elderly are generally similar to those seen in younger patients, although there is a t...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1990-06-01 00:00:00
abstract::Common disease states in gastroenterology are more effectively treated in an obese patient when weight loss is incorporated into the treatment plan. Strategies that seek to achieve weight loss improve outcomes in the treatment of hepatitis C, non-alcoholic fatty liver disease, and colorectal cancer, as examples. Pharm...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2016.07.011
更新日期:2016-12-01 00:00:00