World journal of gastroenterology : WJG
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World J. Gastroenterol. · Aug 2012
CommentOpioid/naloxone prolonged release combinations for opioid induced constipation.
I read with great interest the recent article by Chen et al in a recent issue of your esteemed journal. The article is highly thought provoking. One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations. ⋯ The advantage of oxycodone/naloxone prolonged release (OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release (OXC), it significantly decreases the "Bowel Function Index" thereby ameliorating symptoms of opioid induced constipation to a large extent. Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1. Similarly, Löwenstein et al in another recent study have reported that following a month of therapy, complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.
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World J. Gastroenterol. · Jul 2012
Physical activity, obesity and gastroesophageal reflux disease in the general population.
To clarify the association between physical activity and gastroesophageal reflux disease (GERD) in non-obese and obese people. ⋯ Intermediate frequency of physical activity might decrease the risk of GERD among obese individuals, while no influence of physical activity on GERD was found in non-obese people.
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World J. Gastroenterol. · Jul 2012
Irritable bowel syndrome: physicians' awareness and patients' experience.
To study if and how physicians use the irritable bowel syndrome (IBS) diagnostic criteria and to assess treatment strategies in IBS patients. ⋯ Half of the patients with IBS who consulted a physician received a diagnosis. Awareness and knowledge of diagnostic criteria for IBS differ between SGs and GPs.
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Fibrosis is a chronic and progressive process characterized by an excessive accumulation of extracellular matrix (ECM) leading to stiffening and/or scarring of the involved tissue. Intestinal fibrosis may develop in several different enteropathies, including inflammatory bowel disease. It develops through complex cell, extracellular matrix, cytokine and growth factor interactions. ⋯ The most important soluble factors that regulate the activation of these cells include cytokines, chemokines, growth factors, components of the renin-angiotensin system, angiogenic factors, peroxisome proliferator-activated receptors, mammalian target of rapamycin, and products of oxidative stress. It soon becomes clear that although inflammation is responsible for triggering the onset of the fibrotic process, it only plays a minor role in the progression of this condition, as fibrosis may advance in a self-perpetuating fashion. Definition of the cellular and molecular mechanisms involved in intestinal fibrosis may provide the key to developing new therapeutic approaches.