Abstract:
:A persisting reservoir of the Gulf Coast strain of toxigenic V. cholerae O1 in Louisiana and Texas marshes and the shipment of seafood from these areas throughout the United States means that sporadic cases and outbreaks of cholera may occur anywhere in the country for the foreseeable future. Such cases are most likely to occur during warm months, especially between July and October. Physicians should think of cholera when consulted for severe watery diarrhea, even when the patient has no history of travel, and alert the laboratory. Experience has shown that US food and water sanitation is good enough to make either secondary transmission or large outbreaks unlikely; however, as long as we have foodborne and waterborne outbreaks of bacterial enteric diseases, the Gulf Coast strain may appear in a situation in which it can multiply and be ingested in large numbers by many people. The Latin American cholera epidemic has caused more cases of cholera in the United States in 2 years than the total of Gulf Coast strain cases identified during the past 20 years. The epidemic's future is uncertain. Despite knowing a great deal about cholera epidemiology, we cannot fully explain the ebb and flow of cholera epidemics. We do not know why cholera was apparently eliminated from the Western Hemisphere by 1900, nor can we predict which areas will be affected next or whether cholera will remain in a given area transiently or become endemic. The fact that cholera disappeared from the Western Hemisphere in the last century does not necessarily mean that it will disappear again. The situation is different now in several ways. The current pandemic is caused by the El Tor biotype, which persists better in the environment than does the classical biotype. Travel is now more frequent and more rapid. Finally, the population of the Western Hemisphere is about 14 times larger now than it was in 1850 and produces about 80,000 metric tons of human feces each day, of which only a fraction is treated. Thus, cholera will probably become endemic in Latin America and persist indefinitely.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Blake PAsubject
Has Abstractpub_date
1993-09-01 00:00:00pages
639-60issue
3eissn
0889-8553issn
1558-1942journal_volume
22pub_type
杂志文章,评审abstract::Gastric cancer (GC) is third leading cause of cancer-related death. Only 28.3% of new GC cases survive more than 5 years. Although incidence has declined in the United States, an increase is estimated for 2016. Risk factors include sex (risk is higher in men), Helicobacter pylori infection, heredity, and lifestyle. GC...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2016.04.002
更新日期:2016-09-01 00:00:00
abstract::The role of the aminosalicylates for induction therapy of mild moderate ulcerative colitis and as maintenance treatment has been substantiated by a large series of controlled clinical trials and confirmatory meta-analyses. Both sulfasalazine and newer derivatives are effective in preventing relapses. It remains to be ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2004.02.010
更新日期:2004-06-01 00:00:00
abstract::This article reviews current concepts regarding the pathobiology of cystic fibrosis pancreatic disease. It summarizes recent studies on the relationship between CFTR mutations and pancreatitis, and it reviews several unresolved issues in the field. ...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2004.07.008
更新日期:2004-12-01 00:00:00
abstract::The five different viruses that cause human viral hepatitis, A, B, C, D, and E share the unique property of hepatotropism. Identification of the nucleic acid sequences of each of these viruses, coupled with the application of recombinant DNA technology, has resulted in the rapid development of molecular diagnostic tec...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Inflammatory bowel disease (IBD) is an immune-mediated disease and involves a complex interplay of host genetics and environmental influences. Recent advances in the field, including data from genome-wide association studies and microbiome analysis, have started to unravel the complex interaction between host genetics...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2014.05.003
更新日期:2014-09-01 00:00:00
abstract::The ischemic bowel diseases are a heterogeneous group of disorders usually seen in elderly individuals. They represent ischemic damage to different portions [figure: see text] of the bowel and produce a variety of clinical syndromes and outcomes. Colonic ischemia is the commonest of these disorders and has a favorable...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70190-4
更新日期:2001-06-01 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::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::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::Constipation and diarrhea are common during pregnancy, occurring in up to one-third of women. Constipation is often the result of physiologic changes that occur during pregnancy, usually from hormonal effects on gastrointestinal motility. Diarrhea, on the other hand, is often caused by the same disorders responsible f...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70353-8
更新日期:1998-03-01 00:00:00
abstract::Nutritional strategies have been explored as primary or adjunct therapies for inflammatory bowel disease (IBD). Exclusive enteral nutrition is effective for the induction of remission in Crohn disease and is recommended as a first-line therapy for children. Dietary strategies focus on adjusting the ratio of consumed n...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2017.09.007
更新日期:2018-03-01 00:00:00
abstract::Barrett's esophagus, currently defined as endoscopically apparent columnar metaplasia of the esophagus with histologic documentation of goblet cells, is the precursor to esophageal adenocarcinoma. However, not all patients with this disorder require intensive surveillance. Pathologic diagnosis and grading of dysplasia...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2007.08.004
更新日期:2007-12-01 00:00:00
abstract::Esophageal adenocarcinoma (EAC) has increased dramatically in the past 3 decades, making its precursor lesion Barrett's esophagus (BE) an important clinical problem. Effective interventions are available, but overall outcomes remain unchanged. Most of the BE population remains undiagnosed; most EACs are diagnosed late...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2015.02.008
更新日期:2015-06-01 00:00:00
abstract::CD and UC represent a spectrum of chronic IBD that present in protean ways and are accompanied by a variety of systemic sequelae. Sulfasalazine and the newer 5-aminosalicylates are important in the management of mild-to-moderate disease, whereas corticosteroids remain the primary therapy for most patients with moderat...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70058-3
更新日期:1999-06-01 00:00:00
abstract::Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder, characterized by chronic or recurrent abdominal pain and bloating. Complementary and alternative medicine (CAM) is a diverse group of medical treatments that are not commonly considered to be a part of conventional medicine yet frequently us...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.12.005
更新日期:2011-03-01 00:00:00
abstract::Hepatic injury due to chemicals or natural toxins may occur from occupational, household, or environmental exposure. The liver may dominate the syndrome of toxicity from such agents as carbon tetrachloride, poison mushrooms, and toxic alkaloids, or may be only one facet of more generalized toxicity. The entire histolo...
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::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::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::Patients with chest pain of presumed esophageal origin should be reassured and should undergo an esophageal manometry study. In patients with spastic esophageal disorders, a trial with calcium channel blockers or low-dose antidepressants used as visceral analgesics is the best approach. Inpatients with non GERD-relate...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/S0889-8553(03)00127-4
更新日期:2004-03-01 00:00:00
abstract::The role of hormones and growth factors in the pathogenesis and therapy of colon cancer is biologically intricate and medically important. The effects of the previously described hormones and growth factors on normal and neoplastic colonic growth and development suggest the mechanisms by which hormonal alteration migh...
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::This article examines the transitions in pharmacological therapy for obesity. It reviews the current options approved by the Food and Drug Administration and several drugs approved for other indications that can be used to treat obesity as well. Because weight regulation is complex and redundant systems protect agains...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2010.01.001
更新日期:2010-03-01 00:00:00
abstract::The effect of Helicobacter pylori eradication treatment needs confirmation in patients with persistent symptoms and in those with complicated peptic ulcer. Endoscopic surveillance after eradication is needed in patients with advanced premalignant gastric lesions, previous early gastric cancer, gastric MALT lymphoma, a...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2015.05.006
更新日期:2015-09-01 00:00:00
abstract::Choosing NSAID therapy remains confusing and controversial-the challenge for the clinician is to sum all the risks as well as analgesic and anti-inflammatory efficacy. COX-2 inhibitors are an important scientific advance in pain therapy, and using them in a safe and cost-effective manner is possible when all the compe...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2009.03.006
更新日期:2009-06-01 00:00:00
abstract::Determining the perioperative risks associated with surgical procedures performed in patients with HIV disease is a difficult and complex task. Because HIV is a contagious, blood-borne pathogen, it threatens the health and well-being of both patient and health care provider. Despite poor early results, there is now co...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70300-9
更新日期:1997-06-01 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::Gastric cancers are a histologically heterogenous group of neoplasms arising from unique epidemiologic and molecular backgrounds. There is accumulating evidence that the intestinal type of gastric adenocarcinoma develops through a multistep process beginning with chronic gastritis triggered primarily by Helicobacter p...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2013.01.004
更新日期:2013-06-01 00:00:00
abstract::Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Asia and Latin America. Of 4 million people infected in the United States, a large percentage are immigrants from developing coun...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0889-8553(05)70263-6
更新日期:1996-09-01 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::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::The intestinal immune system is intimately connected with the vast diversity of microbes present within the gut and the diversity of food components that are consumed daily. The discovery of novel molecular mechanisms, which mediate host-microbe-nutrient communication, have highlighted the important roles played by mi...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.gtc.2016.09.004
更新日期:2017-03-01 00:00:00