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 managed care organizations differ in the sophistication of their functional elements, providers and their organizations differ in their ability to shift their focus from the physician-patient relationship to improving the health of a population. As the future of managed care evolves, there are opportunities for those physicians who strive for a greater understanding of the broad spectrum of forces shaping the health care industry.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Behnke LMdoi
10.1016/s0889-8553(05)70328-9subject
Has Abstractpub_date
1997-12-01 00:00:00pages
725-40issue
4eissn
0889-8553issn
1558-1942pii
S0889-8553(05)70328-9journal_volume
26pub_type
杂志文章,评审abstract：:The explanation as to why gastroesophageal reflux disease develops remains unanswered. We have learned much about the regulation of LES pressure, the single most important factor in the development of reflux disease. Our understanding of factors involved in the clearance of refluxed contents has also increased. The pr...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-06-01 00:00:00
abstract：:Hereditary pancreatitis is a clinical condition in which typical pancreatitis is associated with an inheritance pattern strongly suggestive of an autosomal dominant trait. Different variants have been described, some with aminoaciduria and some with ductal anomalies. Recurrent attacks are typical and lead to complicat...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-12-01 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：: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：:Hemorrhoids and anal fissures are common benign anorectal conditions that form a significant part of a colorectal surgeon's workload. This review summarizes and evaluates the current techniques available in their management. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2008.07.001
更新日期：2008-09-01 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：: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：:The presence of stigmata of hemorrhage in a peptic ulcer indicate an increased risk of rebleeding and the need for endoscopic intervention. Clinical trials indicate that laser photocoagulation, multipolar and heater probe coagulation, and injection therapy are all effective in decreasing bleeding from peptic ulcer dis...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-12-01 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：: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：:Despite the availability of a protective vaccine for over 3 decades, the number of persons with chronic hepatitis B virus (HBV) infection remains high. These persons are at risk for cirrhosis and hepatocellular carcinoma. Current treatment is effective at inhibiting viral replication and reducing complications of chro...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2020.01.003
更新日期：2020-06-01 00:00:00
abstract：:Three (author's standard) or five biopsy specimens (two antral, two corpus, one incisura) as suggested by the Sydney system (original and revised version) [figure: see text] correctly separate infected mucosa from uninfected mucosa. No combination identified correctly the presence of intestinal metaplasia to be consid...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70153-9
更新日期：2000-12-01 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：:In conclusion, the availability of liver transplantation has dramatically advanced the management of fulminant hepatic failure. A major responsibility of the gastroenterologist/hepatologist involved in the care of patients with liver failure is early decision making regarding likelihood of spontaneous recovery and con...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-06-01 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：: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：:Irritable bowel syndrome (IBS) is a complex clinical process with multiple pathophysiologic mechanisms. There has recently been a shift in the treatment of patients with severe IBS symptoms to disease-modifying therapies as opposed to symptomatic treatment. Because pathophysiologic differences exist between men and wo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2011.03.012
更新日期：2011-06-01 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：: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：: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 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：: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：: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：: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 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：: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：: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
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：:Overall, fecal markers have been found to be more accurate than serum markers. However, fecal markers are not specific for IBD and may be elevated in a range of organic conditions. Fecal calprotectin and lactoferrin can still differentiate inflammatory disease from functional bowel disorders. Comparison studies have f...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2012.01.007
更新日期：2012-06-01 00:00:00
abstract：:Anal cancer is rare and this helps to explain why anal pre-neoplastic conditions are poorly understood, especially with regard to their natural history and management. Anal intraepithelial neoplasia is closely linked to human papillomavirus infection and is particularly common in homosexuals and in immunosuppressed pa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.08.001
更新日期：2007-12-01 00:00:00
