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[PMID]:28452210
[Au] Autor:Talley NJ
[Ad] Endereço:Faculty of Health and Medicine, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia.
[Ti] Título:Functional Dyspepsia: Advances in Diagnosis and Therapy.
[So] Source:Gut Liver;11(3):349-357, 2017 May 15.
[Is] ISSN:2005-1212
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Functional dyspepsia (FD) is a common but under-recognized syndrome comprising bothersome recurrent postprandial fullness, early satiety, or epigastric pain/burning. Epidemiologically, there are two clinically distinct FD syndromes (although these often overlap clinically): postprandial distress syndrome (PDS; comprising early satiety or meal-related fullness) and epigastric pain syndrome. Symptoms of gastroesophageal reflux disease overlap with FD more than expected by chance; a subset has pathological acid reflux. The pretest probability of FD in a patient who presents with classical FD symptoms and no alarm features is high, approximately 0.7. Coexistent heartburn should not lead to the exclusion of FD as a diagnosis. One of the most exciting observations in FD has been the consistent finding of increased duodenal eosinophilia, notably in PDS. Small bowel homing T cells, signaling intestinal inflammation, and increased cytokines have been detected in the circulation, and elevated tumor necrosis factor-α levels have been significantly correlated with increased anxiety. Postinfectious gastroenteritis is a risk factor for FD. Therapeutic options remain limited and provide only symptomatic benefit in most cases. Only one therapy is known to change the natural history of FD- eradication. Treatment of duodenal eosinophilia is under investigation.
[Mh] Termos MeSH primário: Dispepsia/diagnóstico
Dispepsia/terapia
Período Pós-Prandial
Avaliação de Sintomas
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Duodenopatias/complicações
Duodenopatias/diagnóstico
Dispepsia/etiologia
Eosinofilia/complicações
Eosinofilia/diagnóstico
Refluxo Gastroesofágico/complicações
Refluxo Gastroesofágico/diagnóstico
Azia/complicações
Azia/diagnóstico
Infecções por Helicobacter/complicações
Infecções por Helicobacter/tratamento farmacológico
Helicobacter pylori
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.5009/gnl16055


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[PMID]:29419664
[Au] Autor:Lin H; Wang X; Du X; Wang J; Li Y; Zhang R
[Ad] Endereço:The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou.
[Ti] Título:Effect of Zhizhu Kuanzhong capsule on functional dyspepsia: Protocol for a systematic review and meta-analysis of randomized controlled trials.
[So] Source:Medicine (Baltimore);97(6):e9731, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Functional dyspepsia (FD) is a gastrointestinal disorder affecting people in the globe. Spleen-deficiency syndrome is one of its basic syndromes. Zhizhu Kuanzhong capsule was the most frequent Chinese herbal formula used in the spleen-deficiency researches. We aim to assess the effectiveness and safety of Zhizhu Kuanzhong capsule on FD. METHODS: A systematic literature search for randomized controlled trials (RCTs) from their inception until December 31, 2017 will be conducted using 7 databases: PubMed, Cochrane Library, Embase, VIP Database, Chinese National Knowledge Infrastructure, Wanfang Data, and Chinese BioMedical Database. Inclusion the trials of Zhizhu Kuanzhong capsule which evaluate motilin level, clinical syndrome, and side effect in people with FD. The primary outcome measures will be motilin level, clinical syndrome integral, and clinical total effective rate. Data extraction and risk of bias assessments will be performed by 2 reviewers independently. Methodological and reporting quality of included studies will be assessed by the consolidated standards of reporting trials for Chinese herbal medicine formulas. All statistical analyses will be conducted using RevMan V.5.3 software. Funnel plots, Begg's test, and Egger's test will be developed to evaluate reporting bias. RESULTS: This review will assess the effect of Zhizhu Kuanzhong capsule on clinical total effective rate, symptom remission rate, plasma motilin level, and safety of FD in patients. CONCLUSION: The conclusion of our study will provide updated evidence to judge whether Zhizhu Kuanzhong capsule is an effective intervention for patients with FD.
[Mh] Termos MeSH primário: Medicamentos de Ervas Chinesas/farmacologia
Dispepsia/tratamento farmacológico
Gastroenteropatias/tratamento farmacológico
Metanálise como Assunto
Fitoterapia
Esplenopatias
[Mh] Termos MeSH secundário: Gastroenteropatias/complicações
Gastroenteropatias/diagnóstico
Gastroenteropatias/fisiopatologia
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
Projetos de Pesquisa
Esplenopatias/tratamento farmacológico
Esplenopatias/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drugs, Chinese Herbal)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009731


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[PMID]:27772689
[Au] Autor:Ha YR; Park SY
[Ad] Endereço:Department of Emergency Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Korea.
[Ti] Título:Young Man With Epigastric Pain.
[So] Source:Ann Emerg Med;68(5):e83-e84, 2016 Nov.
[Is] ISSN:1097-6760
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Dor Abdominal/etiologia
Dispepsia/etiologia
Síndrome da Artéria Mesentérica Superior/complicações
Síndrome da Artéria Mesentérica Superior/diagnóstico por imagem
[Mh] Termos MeSH secundário: Dor Abdominal/diagnóstico por imagem
Adulto
Dispepsia/diagnóstico por imagem
Seres Humanos
Masculino
Síndrome da Artéria Mesentérica Superior/cirurgia
Tomografia Computadorizada por Raios X
Ultrassonografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28991940
[Au] Autor:Williams AA
[Ad] Endereço:University of Illinois at Chicago College of Medicine, Chicago, IL, USA. Email: awms@uic.edu.
[Ti] Título:Posttraumatic stress disorder: Often missed in primary care.
[So] Source:J Fam Pract;66(10):618-623, 2017 Oct.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:DeSean W, a 47-year-old man, returned to his primary care clinic with a new complaint of epigastric burning that had been bothering him for the past 4 months. He had tried several over-the-counter remedies, which provided no relief. He also remained concerned--despite assurances to the contrary at previous clinic visits--that he had contracted a sexually-transmitted disease (STD) after going to a bar one night 4 to 5 months ago. At 2 other clinic visits since that time, STD test results were negative. At this current visit, symptoms and details of sexual history were unchanged since the last visit, with the exception of the epigastric pain. When asked if he thought he had contracted an STD through a sexual encounter the night he went to the bar, he emphatically said he would not cheat on his wife. Surprisingly, given his concern, he avoided further discussion on modes of contracting an STD. The physician prescribed ranitidine 150 mg bid for the epigastric burning and explained, once more, the significance of the STD test results. However, he also decided to further examine Mr. W's concern about STDs and the night he may have contracted one. HOW WOULD YOU PROCEED WITH THIS PATIENT?
[Mh] Termos MeSH primário: Transtornos de Estresse Pós-Traumáticos/diagnóstico
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Dispepsia/diagnóstico
Dispepsia/etiologia
Dispepsia/psicologia
Seres Humanos
Masculino
Meia-Idade
Atenção Primária à Saúde
Transtornos Psicofisiológicos/diagnóstico
Transtornos Psicofisiológicos/etiologia
Transtornos de Estresse Pós-Traumáticos/psicologia
Transtornos de Estresse Pós-Traumáticos/terapia
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE


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[PMID]:28854971
[Au] Autor:Chang X; Zhao L; Wang J; Lu X; Zhang S
[Ad] Endereço:Beijing University of Chinese Medicine, Beijing, China.
[Ti] Título:Sini-san improves duodenal tight junction integrity in a rat model of functional dyspepsia.
[So] Source:BMC Complement Altern Med;17(1):432, 2017 Aug 30.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Recent reports have demonstrated that impaired barrier function and local microinflammation in the duodenal mucosa contribute to the pathogeneses of functional dyspepsia (FD). Thus, restoring normal barrier integrity becomes a potential therapeutic strategy in the treatment of FD. Sini-San (SNS) is a traditional Chinese prescription that exhibits therapeutic effects in FD, but the underlying mechanisms remain not well understood. METHODS: FD rats were established by tail clamping method and the therapeutic effect of SNS was evaluated by measuring the visceral sensitivity and gastric compliance. Transepithelial electrical resistance (TEER) that reveals epithelial barrier integrity was measured by Ussing chamber. The expression of tight junction (TJ) proteins, occludin and claudin-1, in the duodenum was determined by Western blot and immunofluorescence. The amount of tumor necrosis factor alpha (TNF-α) and interferon gamma (INF-γ) in duodenal mucosa was detected by enzyme-linked immune sorbent assay (ELISA). The mRNA level of transient receptor potential vanilloid type 1 (TRPV1) was measured by quantitative real time-polymerase chain reaction (qPCR). RESULTS: SNS could improve gastric compliance and attenuate visceral hypersensitivity (VH) in FD rats. TEER was decreased in FD rats, but treatment with SNS restored normal level of TEER and the expression of occludin and claudin-1 in FD rats. In addition, SNS administration ameliorated FD-associated increase in the production of TNF-α, IFN-γ and the expression of TRPV1. CONCLUSIONS: The therapeutic effect of SNS on FD is at least partially through improvement of TJ integrity and attenuation of FD-associated low-grade inflammation in the duodenum. Our findings highlight the molecular basis of SNS-based treatment of FD in human patients.
[Mh] Termos MeSH primário: Medicamentos de Ervas Chinesas/administração & dosagem
Dispepsia/tratamento farmacológico
Junções Íntimas/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Claudina-1/genética
Claudina-1/metabolismo
Duodeno/efeitos dos fármacos
Duodeno/metabolismo
Dispepsia/genética
Dispepsia/metabolismo
Seres Humanos
Interferon gama/genética
Interferon gama/metabolismo
Masculino
Ocludina/genética
Ocludina/metabolismo
Ratos
Ratos Sprague-Dawley
Junções Íntimas/metabolismo
Fator de Necrose Tumoral alfa/genética
Fator de Necrose Tumoral alfa/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Claudin-1); 0 (Drugs, Chinese Herbal); 0 (Occludin); 0 (Tumor Necrosis Factor-alpha); 82115-62-6 (Interferon-gamma)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-017-1938-2


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[PMID]:28779487
[Au] Autor:Cooper TE; Heathcote LC; Clinch J; Gold JI; Howard R; Lord SM; Schechter N; Wood C; Wiffen PJ
[Ad] Endereço:Cochrane Pain, Palliative and Supportive Care Group, Pain Research Unit, Churchill Hospital, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
[Ti] Título:Antidepressants for chronic non-cancer pain in children and adolescents.
[So] Source:Cochrane Database Syst Rev;8:CD012535, 2017 08 05.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time and relief of pain is now seen as important.We designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol) in order to review the evidence for children's pain utilising pharmacological interventions.As the leading cause of morbidity in the world today, chronic disease (and its associated pain) is a major health concern. Chronic pain (that is pain lasting three months or longer) can arise in the paediatric population in a variety of pathophysiological classifications (nociceptive, neuropathic, or idiopathic) from genetic conditions, nerve damage pain, chronic musculoskeletal pain, and chronic abdominal pain, as well as for other unknown reasons.Antidepressants have been used in adults for pain relief and pain management since the 1970s. The clinical impression from extended use over many years is that antidepressants are useful for some neuropathic pain symptoms, and that effects on pain relief are divorced and different from effects on depression; for example, the effects of tricyclic antidepressants on pain may occur at different, and often lower, doses than those on depression. Amitriptyline is one of the most commonly used drugs for treating neuropathic pain in the UK. OBJECTIVES: To assess the analgesic efficacy and adverse events of antidepressants used to treat chronic non-cancer pain in children and adolescents aged between birth and 17 years, in any setting. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online, MEDLINE via Ovid, and Embase via Ovid from inception to 6 September 2016. We also searched the reference lists of retrieved studies and reviews, and searched online clinical trial registries. SELECTION CRITERIA: Randomised controlled trials, with or without blinding, of any dose and any route, treating chronic non-cancer pain in children and adolescents, comparing any antidepressant with placebo or an active comparator. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for eligibility. We planned to use dichotomous data to calculate risk ratio and number needed to treat for one additional event, using standard methods. We assessed the evidence using GRADE and created three 'Summary of findings' tables. MAIN RESULTS: We included four studies with a total of 272 participants (6 to 18 years of age) who had either chronic neuropathic pain, complex regional pain syndrome type 1, irritable bowel syndrome, functional abdominal pain, or functional dyspepsia. All of the studies were small. One study investigated amitriptyline versus gabapentin (34 participants), two studies investigated amitriptyline versus placebo (123 participants), and one study investigated citalopram versus placebo (115 participants). Due to a lack of available data we were unable to complete any quantitative analysis.Risk of bias for the four included studies varied, due to issues with randomisation and allocation concealment (low to unclear risk); blinding of participants, personnel, and outcome assessors (low to unclear risk); reporting of results (low to unclear risk); and size of the study populations (high risk). We judged the remaining domains, attrition and other potential sources of bias, as low risk of bias. Primary outcomesNo studies reported our primary outcomes of participant-reported pain relief of 30% or greater or 50% or greater (very low-quality evidence).No studies reported on Patient Global Impression of Change (very low-quality evidence).We rated the overall quality of the evidence (GRADE rating) as very low. We downgraded the quality of the evidence by three levels to very low because there was no evidence to support or refute. Secondary outcomesAll studies measured adverse events, with very few reported (11 out of 272 participants). All but one adverse event occurred in the active treatment groups (amitriptyline, citalopram, and gabapentin). Adverse events in all studies, across active treatment and comparator groups, were considered to be a mild reaction, such as nausea, dizziness, drowsiness, tiredness, and abdominal discomfort (very low-quality evidence).There were also very few withdrawals due to adverse events, again all but one from the active treatment groups (very low-quality evidence).No serious adverse events were reported across any of the studies (very low-quality evidence).There were few or no data for our remaining secondary outcomes (very low-quality evidence).We rated the overall quality of the evidence (GRADE rating) for these secondary outcomes as very low. We downgraded the quality of the evidence by three levels to very low due to too few data and the fact that the number of events was too small to be meaningful. AUTHORS' CONCLUSIONS: We identified only a small number of studies with small numbers of participants and insufficient data for analysis.As we could undertake no meta-analysis, we are unable to comment about efficacy or harm from the use of antidepressants to treat chronic non-cancer pain in children and adolescents. Similarly, we cannot comment on our remaining secondary outcomes: Carer Global Impression of Change; requirement for rescue analgesia; sleep duration and quality; acceptability of treatment; physical functioning; and quality of life.There is evidence from adult randomised controlled trials that some antidepressants, such as amitriptyline, can provide some pain relief in certain chronic non-cancer pain conditions.There is no evidence from randomised controlled trials to support or refute the use of antidepressants to treat chronic non-cancer pain in children or adolescents.
[Mh] Termos MeSH primário: Dor Abdominal/tratamento farmacológico
Analgésicos/uso terapêutico
Antidepressivos/uso terapêutico
Dor Crônica/tratamento farmacológico
Síndromes da Dor Regional Complexa/tratamento farmacológico
Dispepsia/tratamento farmacológico
Síndrome do Intestino Irritável/tratamento farmacológico
Neuralgia/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Aminas/efeitos adversos
Aminas/uso terapêutico
Amitriptilina/efeitos adversos
Amitriptilina/uso terapêutico
Analgésicos/efeitos adversos
Antidepressivos/efeitos adversos
Criança
Citalopram/efeitos adversos
Citalopram/uso terapêutico
Ácidos Cicloexanocarboxílicos/efeitos adversos
Ácidos Cicloexanocarboxílicos/uso terapêutico
Seres Humanos
Placebos/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Ácido gama-Aminobutírico/efeitos adversos
Ácido gama-Aminobutírico/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Amines); 0 (Analgesics); 0 (Antidepressive Agents); 0 (Cyclohexanecarboxylic Acids); 0 (Placebos); 0DHU5B8D6V (Citalopram); 1806D8D52K (Amitriptyline); 56-12-2 (gamma-Aminobutyric Acid); 6CW7F3G59X (gabapentin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012535.pub2


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[PMID]:28709452
[Au] Autor:Ko SJ; Park JW; Leem J; Kaptchuk TJ; Napadow V; Kuo B; Gerber J; Dimisko L; Yeo I; Lee J; Kim J
[Ad] Endereço:Department of Gastroenterology, College of Korean Medicine, Kyung Hee University, 26 Kyung Heedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
[Ti] Título:Influence of the patient-practitioner interaction context on acupuncture outcomes in functional dyspepsia: study protocol for a multicenter randomized controlled trial.
[So] Source:BMC Complement Altern Med;17(1):363, 2017 Jul 14.
[Is] ISSN:1472-6882
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In the treatment of functional dyspepsia, the placebo effect has been reported to be high, and the influence of the patient-practitioner relationship may be a major component of this effect. The specific and non-specific effects of acupuncture cannot be easily distinguished, and the patient-practitioner relationship may influence the total therapeutic effect in clinical practice. There have been no studies that investigate the influence of patient-practitioner relationship on acupuncture treatment for patients with functional dyspepsia. METHODS: Patients with postprandial distress syndrome, a functional dyspepsia subtype, will be recruited at three hospitals (two in Korea and one in USA) for an international, multi-center, randomized, patient/assessor-blinded, clinical trial. The total anticipated sample size is 88. The participants will be randomly allocated into two groups: an augmented interaction group and a limited interaction group. Acupuncture, with total 12 acupoints, will be performed twice weekly for 4 weeks in both groups. Trained practitioners will provide an "augmented" or "limited" interaction context, as determined by random allocation. The primary outcome measure is the proportion of responders, the proportion of participants who answer "yes" to more than half of the adequate relief questions during the study. Secondary outcome measures include questionnaires for quality of life and symptoms of dyspepsia, and maximum tolerable volume of nutrient drink test. Data will be collected at baseline and following 4 weeks of acupuncture. DISCUSSION: This study will evaluate the influence of the patient-practitioner interaction on clinical effects of acupuncture in patients with functional dyspepsia. TRIAL REGISTRATION: CRIS Identifier: ( KCT0002229 ).
[Mh] Termos MeSH primário: Terapia por Acupuntura
Dispepsia/terapia
Relações Médico-Paciente
Efeito Placebo
[Mh] Termos MeSH secundário: Adulto
Idoso
Seres Humanos
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
República da Coreia
Projetos de Pesquisa
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170716
[St] Status:MEDLINE
[do] DOI:10.1186/s12906-017-1869-y


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[PMID]:28654639
[Au] Autor:Chen Z; Liu L; Tu J; Qin G; Su W; Geng X; Chen X; Wu H; Pan W
[Ad] Endereço:Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
[Ti] Título:Improvement of atropine on esophagogastric junction observation during sedative esophagogastroduodenoscopy.
[So] Source:PLoS One;12(6):e0179490, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND STUDY AIMS: Although sedation esophagogastroduodenoscopy (EGD) is now widely used, previous research has reported that sedation during EGD exhibits a negative effect on esophagogastric junction (EGJ) exposure. Atropine might improve EGJ exposure, as noted in clinical practice. The aim of this study was to examine whether sedation had a negative effect on EGJ observation in the Chinese population, and whether atropine had some ability to act as an antidote to this unexpected secondary effect of sedation. PATIENTS AND METHODS: In this cross-sectional study, subjects were divided into the following three groups according to the methods of EGD examination: the non-sedation group, the propofol-fentanyl combined sedation group and the combined sedation with atropine administration group. The EGJ observation was assessed by a key photograph taken with the endoscopic camera 1 cm from the EGJ, which was rated on the following four-degree scale: excellent (score = 4), good (score = 3), fair (score = 2) and poor (score = 1). RESULTS: The EGJ exposure was better in the sedation group administered atropine (score = 2.64±1.05) than in the sedation group (score = 1.99±1.08, P<0.05) but not as good as in the non-sedation group (score = 3.24±1.12, P<0.05). Reduced detection of EGJ diseases in the sedation group was also found, compared to the non-sedation group (P<0.05). Only the use of atropine (OR = 2.381, 95%CI: 1.297-4.371, P = 0.005) was independently associated with excellent observation of the EGJ during sedation EGD. CONCLUSIONS: Combined propofol-fentanyl sedation reduces the extent of exposure of the EGJ during EGD and reduces the detection of EGJ diseases. The application of atropine in the sedation endoscopy examination helped to achieve better EGJ observation, but still cannot achieve an equal extent of exposure compared to non-sedation EGD.
[Mh] Termos MeSH primário: Atropina
Dispepsia/diagnóstico
Endoscopia do Sistema Digestório/métodos
Junção Esofagogástrica/diagnóstico por imagem
Refluxo Gastroesofágico/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos Transversais
Dispepsia/diagnóstico por imagem
Feminino
Fentanila/uso terapêutico
Refluxo Gastroesofágico/diagnóstico por imagem
Seres Humanos
Hipnóticos e Sedativos/uso terapêutico
Masculino
Meia-Idade
Propofol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 7C0697DR9I (Atropine); UF599785JZ (Fentanyl); YI7VU623SF (Propofol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179490


  9 / 7480 MEDLINE  
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[PMID]:28631728
[Au] Autor:Moayyedi PM; Lacy BE; Andrews CN; Enns RA; Howden CW; Vakil N
[Ad] Endereço:Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.
[Ti] Título:ACG and CAG Clinical Guideline: Management of Dyspepsia.
[So] Source:Am J Gastroenterol;112(7):988-1013, 2017 Jul.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We have updated both the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) guidelines on dyspepsia in a joint ACG/CAG dyspepsia guideline. We suggest that patients ≥60 years of age presenting with dyspepsia are investigated with upper gastrointestinal endoscopy to exclude organic pathology. This is a conditional recommendation and patients at higher risk of malignancy (such as spending their childhood in a high risk gastric cancer country or having a positive family history) could be offered an endoscopy at a younger age. Alarm features should not automatically precipitate endoscopy in younger patients but this should be considered on a case-by-case basis. We recommend patients <60 years of age have a non-invasive test Helicobacter pylori and treatment if positive. Those that are negative or do not respond to this approach should be given a trial of proton pump inhibitor (PPI) therapy. If these are ineffective tricyclic antidepressants (TCA) or prokinetic therapies can be tried. Patients that have an endoscopy where no pathology is found are defined as having functional dyspepsia (FD). H. pylori eradication should be offered in these patients if they are infected. We recommend PPI, TCA and prokinetic therapy (in that order) in those that fail therapy or are H. pylori negative. We do not recommend routine upper gastrointestinal (GI) motility testing but it may be useful in selected patients.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Dispepsia/diagnóstico por imagem
Dispepsia/tratamento farmacológico
Dispepsia/microbiologia
Endoscopia Gastrointestinal
[Mh] Termos MeSH secundário: Antidepressivos Tricíclicos/uso terapêutico
Quimioterapia Combinada
Fármacos Gastrointestinais/uso terapêutico
Infecções por Helicobacter/diagnóstico por imagem
Infecções por Helicobacter/tratamento farmacológico
Helicobacter pylori
Seres Humanos
Inibidores da Bomba de Prótons/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Nm] Nome de substância:
0 (Antidepressive Agents, Tricyclic); 0 (Gastrointestinal Agents); 0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2017.154


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[PMID]:28572654
[Au] Autor:Sayuk GS
[Ad] Endereço:Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA.
[Ti] Título:Editorial: Functional Dyspepsia Treatment: Trials and Tribulations of Targeted Strategies.
[So] Source:Am J Gastroenterol;112(6):910-912, 2017 06.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:While functional dyspepsia (FD) is an exceedingly common disorder, the number of treatment options remains limited, and strategies for the individualized implementation of these therapies largely are lacking. In the current issue of American Journal of Gastroenterology, Saito and colleagues report on a secondary analysis of data from the Functional Dyspepsia Treatment Trial, specifically examining the role of two candidate genetic markers in predicting FD response to antidepressant treatments. Though the current study yielded a negative result, it nevertheless emphasizes the importance of our continued pursuit of therapeutic biomarkers in order to move beyond "one-size-fits-all" approaches to the treatment of FD and related disorders.
[Mh] Termos MeSH primário: Antidepressivos
Dispepsia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Antidepressive Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2017.121



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