Scandinavian journal of gastroenterology. Supplement
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Scand. J. Gastroenterol. Suppl. · Jan 2003
ReviewProbiotics in gastroenterology: indications and future perspectives.
Nowadays. there is a growing interest in probiotics as a safe way of changing the intestinal bacterial flora. Probiotics may have potential in several gastroenterological conditions, especially when the intestinal flora has been disturbed. Most scientific evidence is available for diarrhoea patients treated with Lactobacillus GG, Lactobacillus reuteri or Saccharomyces boulardii. ⋯ Finally, in animal models of colorectal cancer, treatment with probiotics reduces the prevalence of this disease, and in humans the amount of genotoxic substances in faeces has been reduced. In conclusion, the results of studies on the effects of probiotics in gastrointestinal conditions are encouraging. but well-designed placebo-controlled studies are warranted before recommendations for therapeutic or preventive use can be given. Many issues still have to be resolved, including optimal dose and duration of treatment, selection of and differences between the several available probiotic strains, and, importantly, their mechanisms of actions have to be elucidated.
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Scand. J. Gastroenterol. Suppl. · Jan 2001
ReviewRecent developments in Helicobacter pylori vaccination.
This reviews discusses the recent progress in the development of a vaccine against Helicobacter pylori. To date, this gram-negative, spiral-shaped bacterium is one of the most common infections of mankind. Infection usually occurs during childhood, and when left untreated results in lifelong colonization of the stomach. ⋯ Natural infection with H. pylori usually results in a strong inflammatory Th1-type CD4(+)T-cell response that does not seem to have any protective effects. Successful vaccination studies indicate that a Th2-type response is required for protection, but the exact mechanisms involved in protective immunization are still poorly understood. Although commercial development of products for clinical trial is underway, many important issues, such as lack of a suitable mucosal adjuvant, and prevention of potential side effects, such as postimmunization gastritis, need to be resolved.
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Scand. J. Gastroenterol. Suppl. · Jan 2000
ReviewRecent clinical developments in pathophysiology, epidemiology, diagnosis and treatment of intra-abdominal adhesions.
Postsurgical intra-abdominal adhesions pose a significant medical problem in the Western world, and in the past decade progress has been made in understanding their pathophysiology. The early balance between fibrin formation and degradation in the peritoneal cavity during and after surgery seems to be a major determinant of adhesion formation. Postsurgical inhibition of fibrinolytic activity severely impairs fibrin breakdown. ⋯ Roughly 3% of all surgical admissions are associated with intra-abdominal adhesions. Clinical prospective trials have recently been designed to investigate the efficacy of barrier membranes and gels in the reduction of abdominal and pelvic adhesions and prevention of long-term morbidity, e.g., adhesive bowel obstruction and infertility in women. Early results are promising and contribute to the increased interest among clinicians in postsurgical adhesion formation and its consequences.
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Scand. J. Gastroenterol. Suppl. · Jan 1999
ReviewSurgical management of iatrogenic bile duct injury.
At the Academic Medical Center, 133 patients with a bile duct injury after laparoscopic cholecystectomy were treated between 1991 and April 1998. The management of these patients is discussed in a hepato-pancreato-biliary team consisting of radiologist, gastroenterologists and surgeons. In this paper, a summary of the previously reported AMC experience is presented in combination with a reflection of the findings in the literature concerning incidence, aetiology, symptoms, classification, diagnosis and treatment of iatrogenic bile duct injury after laparoscopic cholecystectomy.
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Scand. J. Gastroenterol. Suppl. · Jan 1997
ReviewNew developments in Helicobacter pylori eradication therapy.
The optimal strategy for the eradication of Helicobacter pylori has yet to be determined. This paper summarizes some of the latest treatment strategies for eradicating H. pylori infection. ⋯ Modern combination therapy usually results in an 80-95% H. pylori eradication rate in compliant patients.