European journal of gastroenterology & hepatology
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Eur J Gastroenterol Hepatol · Aug 2002
Comparative StudyFaecal calprotectin: a marker of inflammation throughout the intestinal tract.
To assess the potential of measuring the calcium-binding protein calprotectin in faeces as a method of screening for alimentary inflammation and neoplasia. ⋯ Calprotectin levels are elevated in inflammation and cancer but are not helpful in differentiating between these disorders. In our series, calprotectin was not elevated in colonic polyps or adenomata. Calprotectin could be helpful as a screening method in a general gastroenterology population for inflammatory bowel disease and those with carcinoma, as well as assessing and monitoring disease activity in inflammatory bowel disease.
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Eur J Gastroenterol Hepatol · Jul 2002
Human beta-defensin 2 but not beta-defensin 1 is expressed preferentially in colonic mucosa of inflammatory bowel disease.
Various antimicrobial peptides such as defensins are part of innate immunity and contribute to the intestinal barrier that may be defective in inflammatory bowel disease (IBD). This study investigated beta-defensin mRNA and peptide expression in the colon from controls and patients with Crohn's disease, ulcerative colitis or unspecific colitis as inflammatory controls. ⋯ HBD-1 is expressed constitutively in colonic tissue irrespective of inflammation. HBD-2 is barely present in uninflamed colon but it is induced in inflammation. The lower expression of HBD-2 in Crohn's disease compared with ulcerative colitis indicates different responses of the mucosal innate defence. Defensins may play a crucial role in controlling pathogen invasion in IBD, although the functional significance remains to be established.
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Eur J Gastroenterol Hepatol · May 2002
CommentCan risk stratification improve the management of acute upper-gastrointestinal bleeding?
Acute upper-gastrointestinal bleeding is a common indication for emergency admission to hospital. Risk-stratification scores have been devised to identify patients at risk of re-bleeding or death, but these have usually required both clinical and endoscopic assessment. ⋯ While each of these studies has individual merit, both are unable to answer the question of whether risk stratification improves health outcomes or resource use in acute gastrointestinal haemorrhage. They will nevertheless help the development of guidelines that enable patients to be managed more efficiently and outcomes to be compared more fairly.
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Eur J Gastroenterol Hepatol · Apr 2002
Randomized Controlled Trial Multicenter Study Clinical TrialManagement of Lithuanian children's acute diarrhoea with Gastrolit solution and dioctahedral smectite.
Acute gastroenteritis represents a major cause of morbidity and mortality worldwide among children, and rehydration treatment has been one of the cornerstones in the management strategy. The natural clay dioctahedral smectite (Smecta) increases intestinal barrier function and is effective against infectious diarrhoea in children. The purpose of this work was to compare the efficacy and tolerance of Lithuanian children's diarrhoea treatment with dioctahedral smectite combined with hypotonic oral rehydration solution (ORS)--Gastrolit--versus Gastrolit alone to establish the influence of Smecta on serum electrolyte balance in young children with diarrhoea and mild or moderate dehydration. ⋯ Smecta significantly reduced the duration of diarrhoea, was safe and well tolerated, and had no impact on the adsorption of electrolytes. Smecta could be used together with ORS in children suffering from acute gastroenteritis (without uncontrollable vomiting) with mild and moderate dehydration.
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Eur J Gastroenterol Hepatol · Apr 2002
Establishing patient preferences for gastroenterology clinic reorganization using conjoint analysis.
The Department of Health states that patients with suspected cancer should be seen within 2 weeks, and the Patients' Charter suggests that patients should not wait for more than 30 min in outpatients. Decisions such as these are often made with little assessment of patient preferences. We have elicited patient preferences for the optimal use of time in the outpatient clinic. ⋯ The present Department of Health recommendations and the Patients' Charter are too simplistic and do not take into account patient preferences.