Abstract：
:Treatment with a combination of radiation therapy and chemotherapy currently allows about 80 per cent of patients with epidermoid carcinomas of the anal canal to retain anorectal function, with about a 70 per cent likelihood of cure at 5 years. In these programs, radical surgery is reserved for the management of residual cancer or of radiation- or chemotherapy-induced anorectal toxicity. Several different schedules of combined modality therapy are in use, but an important common element in most schedules appears to be the concurrent administration of radiation and 5-fluorouracil. The improvement in local control rates with combined radiation and chemotherapy, as compared to most series treated by either radical radiation or radical surgery, has not been matched by a marked improvement in survival rates, and the risk of distant metastases does not appear to have been altered by these combinations. The success of the combinations in improving local control has allowed the indications for local excision to be defined more narrowly, and should reduce the risks of local recurrence associated with conservative surgery.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Cummings BJsubject
Has Abstractpub_date
1987-03-01 00:00:00pages
125-42issue
1eissn
0889-8553issn
1558-1942journal_volume
16pub_type
杂志文章,评审abstract：:CP remains a challenging disease. Endoscopic and surgical management, along with antioxidants, have helped in reducing chronic pain. Management of exocrine and endocrine insufficiency forms the cornerstone for improving nutrition in these patients. Newer therapeutic targets that will transcend the management of CP bey...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.12.009
更新日期：2012-03-01 00:00:00
abstract：:Rarely do otherwise safe drugs administered at recommended doses produce liver damage that may progress to liver failure and death. Because we are generally unable to identify the patients most susceptible to this "idiosyncratic" form of toxicity, many potentially useful medications are not made available to patients....
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:The past decade has seen an alarming increase in the burden of disease associated with Clostridium difficile. Several studies have now demonstrated an increasing incidence of C difficile infection in patients with inflammatory bowel disease (IBD) with a more severe course of disease compared with the non-IBD populatio...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2009.07.003
更新日期：2009-12-01 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：: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：:Pediatric patients with inflammatory bowel disease (IBD) stand to benefit from quality improvement (QI) due to the chronic nature of the disease, frequent interaction with the health care system, and exposure to high-risk treatments. The use of QI in health care has led to significant improvements in quality and relia...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.07.013
更新日期：2018-12-01 00:00:00
abstract：:High-resolution manometry (HRM) allows nuanced evaluation of esophageal motor function, and more accurate evaluation of lower esophageal sphincter (LES) function, in comparison with conventional manometry. Pathophysiologic correlates of gastroesophageal reflux disease (GERD) and esophageal peristaltic performance are ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2013.11.005
更新日期：2014-03-01 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：:The intent of this article is to summarize the primary structures (that is, amino acid sequences) localization, primary gastrointestinal and pancreatic actions, and possible clinical relevance of the major gut peptides as well as some of the miscellaneous gut peptides. A brief overview of the general characteristics o...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-12-01 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：:The lower esophageal sphincter, crural diaphragm, and phrenoesophageal ligament are the anatomic structures that constitute the antireflux barrier. The intraluminal pressure at the esophagogastric junction (EGJ) reflects the strength of the antireflux barrier. The end-expiratory pressure is a result of the tonic activ...
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：:Intestine transplant is indicated for patients with intestinal failure who are unable to be weaned from parenteral nutrition (PN). Long-term PN, although life sustaining in many patients, can be associated with life-threatening complications including PN-associated liver disease (PNALD). Most patients are not consider...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.01.001
更新日期：2007-03-01 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：:Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mallory-Weiss lesions, ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2014.08.004
更新日期：2014-12-01 00:00:00
abstract：:The health care burden of hepatitis C virus (HCV) infection is projected to continue to increase over the next two decades, so improving the efficacy of anti-HCV therapy has the potential to significantly affect health care utilization associated with the disease. Adherence to standard combination therapy and maintain...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.gtc.2003.12.003
更新日期：2004-03-01 00:00:00
abstract：:Autoimmune pancreatitis is the pancreatic manifestation of a systemic disorder that affects various organs, including the bile duct, retroperitoneum, kidney, and parotid and lacrimal glands. It represents a recently described subset of chronic pancreatitis that is immune mediated and has unique histologic, morphologic...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.gtc.2008.02.004
更新日期：2008-06-01 00:00:00
abstract：:As the AIDS epidemic continues to grow, it becomes increasingly important that physicians are aware of the gastrointestinal and abdominal diseases specific to this group of patients. Most AIDS patients exhibit gastrointestinal symptoms at some time during the course of their disease. Clinical AIDS is often determined ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-06-01 00:00:00
abstract：:The past decade has seen the introduction of a number of new potent antimicrobial agents, including broad-spectrum beta-lactam compounds such as the ureidopenicillins, third-generation cephalosporins, carbapenems, and monobactams; combinations of penicillins with inhibitors of beta-lactamase; and the quinolones. Most ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:Gastroesophageal reflux disease (GERD) is defined by either subjective complaints indicative of problematic gastroesophageal reflux or objective complications directly attributable to reflux. Studies focused on GERD-related symptoms suggest a worldwide increase in prevalence of approximately 4% per year. Epidemiologic...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2008.09.009
更新日期：2008-12-01 00:00:00
abstract：:The goal of nutritional support in acute pancreatitis is to reduce inflammation, prevent nutritional depletion, correct a negative nitrogen balance, and improve outcomes. Enteral nutrition (EN) in severe acute pancreatitis (SAP) should be preferred to parenteral nutrition. It maintains the integrity of the gut barrier...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2017.10.002
更新日期：2018-03-01 00:00:00
abstract：:Celiac disease is a common immune-mediated disorder that occurs in individuals with permissive genetics (HLA-DQ2/DQ8 genotype) following exposure to certain wheat proteins. The histopathologic manifestations of small intestinal mucosal injury (villus atrophy, crypt hyperplasia, and intraepithelial lymphocytosis) are w...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.09.003
更新日期：2019-03-01 00:00:00
abstract：:This brief review summarizes the physiology and pharmacology of eicosanoids and describes how they have been tested for possible application in liver disease and transplantation. The objective is to trace the stepwise application from the laboratory to the bedside. Although many questions remain to be answered, the ob...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70254-5
更新日期：1996-06-01 00:00:00
abstract：:In patients with Crohn's disease on biologic medications, the use of therapeutic drug monitoring leads to a personalized approach to optimize treatment. Using an algorithmic approach, measurement of drug concentrations and anti-drug antibodies can be used to improve treatment outcomes. Therapeutic drug concentrations ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2017.05.014
更新日期：2017-09-01 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：:The management of recurrent, symptomatic malignant ascites can be problematic for physicians and patients. The most common, low-risk method is large-volume paracentesis. Patient disease progression often leads to rapid reaccumulation of ascites, which requires frequent return visits to the hospital for symptom managem...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2005.12.006
更新日期：2006-03-01 00:00:00
abstract：:Topical therapy with amino salicylate enemas is the treatment of choice for proctitis, proctosigmoiditis, and left-sided ulcerative colitis. Adjunctive sulfasalazine therapy is often required. Relapse rates of 80 per cent can be expected within 3 months of discontinuing therapy. ...
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：:Ulcerative colitis and Crohn disease are chronic inflammatory diseases with typical onset in early adulthood. These diseases, therefore, can affect a woman throughout the many stages of her life, including menstruation, sexuality, pregnancy, and menopause. Unique health issues face women during these stages and can af...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2016.02.007
更新日期：2016-06-01 00:00:00
abstract：:Pediatric pancreatitis is an emerging field with an increasing incidence of disease. Management of pediatric pancreatitis is understudied and, therefore, extrapolated from adult studies (although the etiologies are different). There is evidence that feeding is safe in mild acute pancreatitis in children without increa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.07.003
更新日期：2018-12-01 00:00:00
abstract：:This article reviews the role of therapeutic endoscopy in the diagnosis and treatment of nonvariceal upper and lower gastrointestinal (GI) hemorrhage. The initial approach to patients with GI bleeding is reviewed. Endoscopic treatment of various stigmata of recent peptic ulcer hemorrhage is discussed in detail. Manage...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70123-0
更新日期：2000-06-01 00:00:00
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 month...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-12-01 00:00:00
