Abstract：
:The delivery of medical care is undeniably changing. Resources are becoming increasingly scarce, and the progressive rise of health care expenditures needs to be restrained. Although the field of outcomes assessment is not well understood, it is increasingly being applied to the practice of medicine. The underlying goal of outcomes management should be to improve quality by identifying the most efficient use of finite resources and integrating these into practice guidelines. Although reduction of health care costs is important, it should be a secondary goal. Providers of health care must take an active role in outcomes research and management both in understanding and in implementing these techniques in medical practice. In doing so, it is essential that physicians maintain the proper emphasis on quality patient care.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Johanson JFdoi
10.1016/s0889-8553(05)70338-1subject
Has Abstractpub_date
1997-12-01 00:00:00pages
859-71issue
4eissn
0889-8553issn
1558-1942pii
S0889-8553(05)70338-1journal_volume
26pub_type
杂志文章,评审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 resid...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-03-01 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：:Lymphocyte homing antagonists represent promising therapeutic agents for the treatment of idiopathic inflammatory bowel disease (IBD). Several critical molecules involved in the recruitment of inflammatory cells in the intestine, including integrins and chemokine receptors, have been successfully targeted for the trea...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2014.05.012
更新日期：2014-09-01 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：: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：:Numerous extraintestinal diseases have been associated with IBD. The role of the gastrointestinal tract in host response to the foreign antigens present in the gut makes the enteric immune system highly susceptible to any external perturbation to the system. Dysregulation of the enteric immune response results in path...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(01)00019-x
更新日期：2002-03-01 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：: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：: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：:Gallstones are common with prevalences as high as 60% to 70% in American Indians and 10% to 15% in white adults of developed countries. Ethnic differences abound with a reduced frequency in black Americans and those from East Asia, while being rare in sub-Saharan Africa. Certain risk factors for gallstones are immutab...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2010.02.003
更新日期：2010-06-01 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：: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 likel...
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：:Endoscopic approaches have revolutionized the palliation of advanced pancreatic cancer. The ideal management consists of a multidisciplinary approach involving surgeons, endoscopists, radiologists, and oncologists. Concurrent advances in the fields of interventional radiology and laparoscopic surgical oncology should ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.04.001
更新日期：2007-06-01 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：: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：: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
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：:Barrett's metaplasia develops in 6% to 14% of individuals with gastroesophageal reflux. Barrett's adenocarcinomas are increasing in epidemic proportions for, as yet unknown, reasons; approximately 0.5% to 1% of patients with Barrett's metaplasia develop adenocarcinoma. Heartburn duration and frequency (but not severit...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70098-4
更新日期：1999-12-01 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：:Nonalcoholic fatty liver disease (NAFLD) represents a global public health burden. NAFLD, while strongly associated with the metabolic syndrome, can occur independently from existing metabolic diseases. In addition to liver-related disease burden and mortality, significant extrahepatic disease outcomes coexist with NA...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2019.10.002
更新日期：2020-03-01 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：: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：: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：: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：:Surveillance for hepatocellular carcinoma (HCC) has become routine despite a lack of evidence of efficacy. Suitable candidates for surveillance include patients with cirrhosis and some subsets of noncirrhotic chronic hepatitis B carriers. The best surveillance testis ultrasonography at 6- to 12-month intervals. Serolo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2004.04.012
更新日期：2004-09-01 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：: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：: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：:Foreign body ingestion is a common occurrence in children and in specific high-risk groups of adults such as those with underlying esophageal disease, prisoners, the mentally retarded, and those with psychiatric illnesses. Although most foreign bodies pass through the gastrointestinal tract without difficulty, sharp, ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
