1,721,017 research outputs found
Trimebutine: a state-of-the-art review
No full textLa trimebutina maleato è stata ampiamente utilizzata, a partire dalla fine degli anni ‘60, per il trattamento dei disturbi funzionali gastrointestinali, compresa la sindrome dell’intestino irritabile (IBS). Normalmente la trimebutina viene inclusa
nella classe degli agenti antispastici, ma le sue proprietà la rendono un composto ineguagliabile e polivalente. L’efficacia
nell’alleviare il dolore addominale è stata dimostrata in vari studi clinici con differenti protocolli di trattamento. Il
principale effetto, inizialmente, è stato ritenuto imputabile unicamente alla sua attività antispastica, ma ulteriori ricerche
hanno messo in evidenza conoscenze sempre più approfondite sulla sua utilità terapeutica in numerose patologie dell’apparato gastrointestinale. Le azioni della trimebutina sono mediate attraverso un effetto antagonista sui recettori periferici Mu (μ), kappa (κ) e delta (δ) degli oppioidi e una modulazione nel rilascio di peptidi gastrointestinali. Gli effetti ultimi sulla motilità gastrointestinale sono riassumibili in un’accelerazione dello svuotamento gastrico, un’induzione prematura della fase III del complesso motorio migrante nell’intestino tenue e una modulazione dell’attività contrattile del colon.
Inoltre, è stato dimostrato che la trimebutina ha un ruolo nella regolazione della sensibilità viscerale. È stato riscontrato
che tale farmaco è anche un modulatore dei canali ionici intestinali. Grazie alla sua attività a vari livelli, dalla motilità
gastrointestinale al controllo del dolore, la trimebutina può essere considerata un farmaco unico e per il suo spettro d’azione
può essere utilizzata per il trattamento sia dei disturbi di ipermotilità che di ipomotilità, ivi compresa la sindrome
dell’intestino irritabile, la dispepsia e altre patologie funzionali gastrointestinali. Il presente articolo fornisce una panoramica
generale sulle conoscenze attuali dei meccanismi farmacologici della trimebutina e le sue applicazioni cliniche nei
disturbi gastrointestinali. Le sue proprietà biochimiche e i complessi meccanismi d’azione, unitamente a una sicurezza
farmacologica ampiamente studiata, rendono questo composto ancora del tutto attuale e insostituibile
Unsuccessful octreotide treatment of the watermelon stomach
No full textFor several years, antrectomy has been the treatment of choice to manage gastric hemorrhage in patients with diffuse gastric antral angiodysplasia, a rare cause of chronic gastrointestinal bleeding (1). Recently, different nonsurgical treatments have been proposed, including endoscopic and medical options (2-5). Because somatostatin and octreotide have been used successfully to prevent gastrointestinal bleeding due to peptic diseases, esophageal varices (6,7), and more recently, diffuse small bowel angiodysplasia (8-10), we wished to test the efficacy of octreotide on diffuse antral angiodysplasia
Night shifts and consumption of energy drinks by healthcare personnel
Full text linkThe consumption of drinks with a high caffeine content is a growing phenomenon not only among young people but also among individuals who work night shifts, including healthcare workers. In young people, the motivations that lead to taking energy drinks are linked to performance in studies and recreational activities. In healthcare workers, the motivations are linked to work performance and the need to maintain a high level of wakefulness during the night. This review analyzes the studies published on the consumption of energy drinks in healthcare personnel and the changes that have occurred in recent years also following the stress caused by the recent pandemic on healthcare
How should Helicobacter pylori negative patients be managed?
Full text linkDyspepsia is a digestive syndrome distinct from (although frequently overlapping with) gastroesophageal reflux disease (GORD) and irritable bowel syndrome (IBS), which is characterised by various combinations of painful and non-painful symptoms arising from the epigastrium. Dyspepsia can be secondary to a variety of diseases, but in most instances it is idiopathic. Helicobacter pylori infection is responsible for the majority of peptic ulcers and of other diseases potentially associated with dyspepsia. Nevertheless, a causal role for H pylori infection in symptom occurrence has not been established. Experimental data indicate that H pylori eradication does not improve symptoms in the majority of dyspeptic patients. It has been proposed recently that H pylori negative patients should be managed according to their clinical presentation. Some reports suggest that taking into consideration the most relevant or 'predominant' symptom may help to identify distinct subgroups among dyspeptic patients with different underlying pathophysiological abnormalities and different responses to treatment. Well designed and conducted prospective studies are needed to verify whether treatment of H pylori negative dyspeptic patients based on the predominant symptom actually is a cost effective approach
Management of dyspeptic patients by general practitioners and specialists
Full text linkTherespectiverolesofgeneralpractitioners andspecialistsinthemanagementofmostdiseasesisnotclearlyde®nedanddyspepsiaisno exception.Ideally,thedivisionoftasksshould bebasedonthecharacteristicsofdiVerentdiseasesandonspeci®cobjectives. Theprevalenceofdyspepsiarangesbetween 20and40%inindustrialisedcountriesand roughly25%ofpatientsseekmedicalhelp, whereastheremainderoftenself-medicate.1 Althoughfrequentlyidiopathic(orfunctional), dyspepsiacanbesecondarytoavarietyofserious(andsometimesfatal)organic,systemic andmetabolicdiseasesthatneedtobe identi®ed.Functionaldyspepsiaalsoprecipitatesasubstantialreductioninthequalityof lifeofaVectedpatientswithrelevantcostsfor society.Thecurrenteconomicrestrictionspreventreferralofeverypatientandcorrectmanagementofdyspepsiaisaformidabletask. Prospectivestudieshavebeenundertakento establishtherespectiveeVectivenessofdiVerentdoctorsinthemanagementofsomegastroenterologicaldiseases.Zarlingetalcompared theeYcacyofmanagementofacutediverticulitisprovidedbygeneralpractitioners,internistsandgastroenterologists,andobserved shorterhospitalstayandlowerreadmission ratesinpatientstreatedbygastroenterlogists.2 Unlikeacutediverticulitis,dyspepsiaisavery heterogeneousconditionandnosimilarstudies areavailableasyet.Tacklingthefollowing questionsmayhelptoelucidatetheremitof diVerentdoctors. +Whatdrivesadyspepticindividualto consultaphysician? +DodiVerentdoctorsseediVerenttypesof dyspepticpatients? +Whatisthediagnosticyieldofanextensive work-upbyaspecialist? +ShoulddiVerentdoctorsadoptdiVerent strategiesforthemanagementofdyspepsia? +Whatisthemostcost-eVectivewaytomanagedyspepsia
Review article: The continuing dilemma of dyspepsia
No full textDyspepsia drains a substantial proportion of healthcare resources in industrialized countries and an appropriate management strategy is needed. An aetiological role for Helicobacter pylori infection has been demonstrated in a number of pathological conditions associated with dyspepsia, such as peptic ulcer and gastric malignancies, but not in functional dyspepsia. Endoscopy and diagnosis-based treatment, H. pylori testing and eradication therapy, history taking and empirical therapy, are the main tools that are currently available for managing patients with upper gastrointestinal symptoms. Endoscopy identifies malignancies and organic diseases of the proximal gut and therefore provides reassurance to both doctors and patients. It should be recommended in older patients with suspicious symptoms and it has proven to be more cost-effective than empirical H2-receptor antagonists in patients with ulcer-like symptoms. Empirical eradication in all dyspeptics without suspicious symptoms is a cost-effective approach that cures the majority of peptic ulcers. Nevertheless, it does not control symptoms in the majority of patients, it may exacerbate gastro-oesophageal reflux disease, and it encourages antibiotic resistance. The realities of current clinical practice require empirical therapy in most, if not all, the dyspeptics seen by general practitioners. A detailed history taking can help to diagnose gastro-oesophageal reflux disease and to identify suspicious symptoms. Furthermore, identification of dyspepsia subgroups may provide guidance for empirical therapy. Nevertheless, even analysis of individual symptoms does not provide a sufficient diagnostic yield to differentiate functional from organic dyspepsia and appropriate investigations are needed in patients with poor response to short-term therapy or frequent relapses
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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