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 convincing evidence that HIV infection is not a significant, independent risk factor for major surgical procedures. In practice, the authors evaluate the risk of surgery in patients with HIV infection using the same basic tools and guidelines applied to the uninfected, with the best predictors of surgical morbidity and mortality stemming from a careful and accurate assessment of the patient's cardiopulmonary, renal, endocrine, and nutritional reserve. Although HIV disease provides a unique constellation of diagnoses and challenges to the health care provider, the risk of major surgery in this population is not unlike that for other immunocompromised or malnourished patients. The authors believe that members of the surgical team have a professional, moral, and ethical responsibility to provide the highest possible quality of care for their patients, regardless of their HIV status. If after weighing the risks and benefits to the patient the surgeon believes the procedure will have a positive effect on the patient's life, the surgeon must offer surgical treatment. To do less does a disservice to the patient, the provider, and the profession as a whole.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Harris HW,Schecter WPdoi
10.1016/s0889-8553(05)70300-9subject
Has Abstractpub_date
1997-06-01 00:00:00pages
377-91issue
2eissn
0889-8553issn
1558-1942pii
S0889-8553(05)70300-9journal_volume
26pub_type
杂志文章,评审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：: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：: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：:Women have started to enter gastroenterology (GI) in significant numbers over the past 5 years, although they are still underrepresented compared with the proportion of female graduating medical students. This underrepresentation is most likely caused by the culture of GI where female students and residents have felt ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.03.004
更新日期：2011-06-01 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：: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：:Obesity-related disorders derive from a combination of genetic susceptibility and environmental factors. Recent evidence supports the role of gut microbiota in the pathogenesis of obesity, type 2 diabetes mellitus, and insulin resistance by increasing energy harvest from diet and by inducing chronic, low-grade inflamm...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2012.08.009
更新日期：2012-12-01 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 incidence of adenocarcinoma of the esophagus is rapidly increasing in the Western world. In North America and western Europe, a marked shift in the epidemiologic profile of this disease has occurred. In the past, most patients with esophageal cancer were found to have epidermoid carcinoma. These patients frequentl...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70319-8
更新日期：1997-09-01 00:00:00
abstract：:This article has reviewed the morphologic features of BE and its complications of dysplasia and adenocarcinoma in routinely processed endoscopic biopsy and resection specimens. In addition, the problems related to the diagnosis of dysplasia in tissue samples have been analyzed, and the role of esophageal brush cytolog...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70309-5
更新日期：1997-09-01 00:00:00
abstract：:Corticosteroids are a nonspecific immune modulator used in the treatment of ulcerative colitis. Topical and systemic forms of corticosteroids have been shown to be effective in induction of clinical remission and remain first-line therapy for acute severe ulcerative colitis. A large proportion of patients experience a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2020.08.001
更新日期：2020-12-01 00:00:00
abstract：:Endoscopic retrograde cholangiopancreatography is an effective platform for a variety of therapies in the management of benign and malignant disease of the pancreas. Over the last 50 years, endotherapy has evolved into the first-line therapy in the majority of acute and chronic inflammatory diseases of the pancreas. A...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2015.10.009
更新日期：2016-03-01 00:00:00
abstract：:Precursor lesions in the GIT include flat dysplasias, adenomas, dysplasia superimposed on nonneoplastic polyps, endocrine cell dysplasia, ACF, and condyloma accuminatum. Interobserver variability can be a problem in reporting dysplasia, and ancillary techniques including flow cytometry, image analysis, proliferation m...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(02)00007-9
更新日期：2002-06-01 00:00:00
abstract：:Probiotics have been studied in a variety of GI infections, and are an appealing concept given their favorable safety profiles. Several placebo-controlled trials indicated that lactobacilli have a suppressive effect on H pylori infection. Although some studies reported improvement in H pylori eradication, others faile...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2006.03.005
更新日期：2006-06-01 00:00:00
abstract：:In most patients presenting with acute pancreatitis, the cause can be established on the basis of initial history, physical examination, laboratory studies, and abdominal sonography. Patients with unexplained pancreatitis at that point are often considered to have idiopathic disease. However, a cause and, often, effec...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
abstract：:Managed care organizations and their products will continue to change in response to consumer demands, competitive pressures, and regulatory requirements. Providers who gain an understanding of the world managed care organizations live in can also expect to influence these organizations for mutual benefit. Just as man...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70328-9
更新日期：1997-12-01 00:00:00
abstract：:A variety of infectious enteric pathogens (bacterial, viral, and protozoal) can lead to a systemic diarrheal illness in international travelers traveling from industrialized countries to developing areas of the world. Many of the agents that lead to this syndrome have been identified, and their mode of transmission ha...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-09-01 00:00:00
abstract：:Biliopancreatic diversion is a very effective method for weight reduction. In some instances it is too effective and needs to be revised. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：
更新日期：1987-09-01 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：: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：:Because functional bowel disorders have no reliable markers, they must be defined by their symptoms. The various constellations of symptoms (syndromes) may have different mechanisms, differential diagnoses, and treatments. Therefore, precise classification is important on clinical and scientific grounds. Functional bo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-06-01 00:00:00
abstract：:Diagnostic angiography still plays an essential role in the diagnosis of patients,particularly those with acute lower GI bleeding. Transcatheter therapy appears to be a viable treatment alternative in selected patients with GI bleeding. Many interventionists today believe embolotherapy to be more effective initially a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.gtc.2005.09.001
更新日期：2005-12-01 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：:Hepatocellular carcinomas can be further divided into distinct subtypes that provide important clinical information and biological insights. These subtypes are distinct from growth patterns and are on based on morphologic and molecular findings. There are 12 reasonably well-defined subtypes as well as 6 provisional su...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2017.01.009
更新日期：2017-06-01 00:00:00
abstract：:The goal of antiviral treatment of chronic hepatitis B is to prevent the complications of cirrhosis, hepatic decompensation, HCC, and death. Because these clinical outcomes may take a long period of time to develop, it is important to use intermediate or surrogate end points to evaluate the efficacy and response to an...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.06.004
更新日期：2011-09-01 00:00:00
abstract：:Successful treatment of unresectable and metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) requires the thoughtful choice of systemic therapy as a component of a multidisciplinary therapeutic approach. The role of somatostatin analogues is established in symptom relief, but the efficacy of interferon ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2010.08.013
更新日期：2010-09-01 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：:This article defines obesity, ideal body weight, morbid obesity, and indexes of overweight, pointing out some of the difficulties in studies of the epidemiology of morbid obesity. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：:Constipation, diarrhea, and symptomatic hemorrhoids are disorders common in the general population, particularly in women. These conditions, if mild, often are self-treated with various home remedies or nonprescription preparations. Few of these patients, moreover, are referred to gastroenterologists, as primary care ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(02)00069-9
更新日期：2003-03-01 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
