摘要:

Colon cancer was rare or uncommon in the past, and still is in traditionally-living third world populations. It now affects 3-5% of western populations. Epidemiological, case control, experimental and other studies suggest that proneness to colon cancer can be lessened by major dietary changes, principally decreasing fat intake by a third, and doubling the intake of fiber-containing foods, especially vegetables and fruit – recommendations similarly advocated for the avoidance of coronary heart disease and other degenerative diseases. Among nondietary factors, evidence indicates familiality, obesity and atmospheric pollution to be contributory, while parity, physical activity, solar radiation, high social class, estrogen use, and aspirin use, appear protective. Despite insufficiencies of knowledge of prevention, avoiding action should certainly be taken by those familially prone. For the rest, conceivably a prudent life-style could benefit a proportion avoiding colon cance

ISSN:0257-2753    

DOI:10.1159/000171424

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The standard treatments for inflammatory bowel disease have been aminosalicylates and corticosteroids, administered both systemically and topically. They are frequently extremely effective, especially at higher doses. Unfortunately steroid side effects are too frequent and agents with low systemic bioavailability (budesonide, beclamethasone and tixocortol) are being investigated. Azathioprine, although a useful adjunct to steroids, has occasional and unpredictable severe side effects. Cyclosporin is an important new therapy in severe refractory disease. Several new phospholipid mediator inhibitors, mepacrine, zileuton, and ridogrel, may be useful in moderate colitis. Other topical treatments, butyrate, acetarsol and bismuth subsalicylate, can be beneficial in refractory distal disease. Quadruple antimycobacterials, antioxidants and antimicrobials warrant further study, while newer immunosuppressives such as methotrexate, FK 506 and monoclonal antibodies against helper T lymphocytes show some early promise.

ISSN:0257-2753    

DOI:10.1159/000171425

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In the last decade research on antiemetic therapy has determined relevant advances in the prevention of chemotherapy-induced emesis. In fact, 70-80% of patients submitted to highly or moderately emetogenic drugs achieve complete protection against vomiting during the first cycle of chemotherapy. In the prevention of acute emesis induced by a high single dose ( ≧ 50 mg/m2) or a low dose (20-40 mg/m2) of cisplatin repeated for 4-5 days, a combination of ondansetron plus dexamethasone was shown to be more efficacious and less toxic than the combination of high dose metoclopramide plus dexamethasone plus diphenhydramine. Few studies have been performed for the prevention of delayed emesis induced by cisplatin. At present, the combination of oral dexamethasone plus metoclopramide seems to offer the best protection and should be considered the treatment of choice. For the prevention of acute emesis induced by moderately emetogenic drugs, corticosteroids (dexamethasone and methylprednisolone) and the new 5-HT3 receptor antagonists have a similar efficacy and a low toxicity. On a cost basis, corticosteroids must be considered the drug of choice while 5-HT3 receptor antagonists should be used only in patients refractory to corticosteroids or in those who cannot tolerate the

ISSN:0257-2753    

DOI:10.1159/000171426

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

To analyze postprandial gastroesophageal reflux by means of ambulatory gastroesophageal pH monitoring for 24 h, four groups were studied prospectively: group A: 22 healthy volunteers; group B: 31 consecutive patients undergoing medical treatment for gastroesophageal reflux, group Cl: 20 consecutive patients with symptomatic reflux awaiting surgical treatment by means of Nissen fundoplication (pre-Nissen evaluation) and group C2: group C1 patients reevaluated 6 months postoperatively (post-Nissen evaluation). Gastroesophageal pH, as a measure of post-prandial reflux following the main meal of the day was evaluated by the Kaye test. In groups B, C1 and C2, esophageal manometry was also performed. Gastroesophageal pH monitoring revealed significant qualitative as well as quantitative differences in postprandial gastroesophageal reflux experienced by healthy subjects (group A) and surgically treated patients (group C2) compared to patients with pathologic reflux (groups B and C1). The postprandial reflux was significantly more acid and more important (Kaye’s test value) in groups Cl and B than in groups A and C2. There were no differences in postprandial reflux between healthy subjects and patients treated by Nissen fundoplication (group C2). Only the pressure and length of the lower esophageal sphincter (LES) showed differences after Nissen fundoplication. We conclude that patients with pathologic reflux have more severe postprandial reflux than normal subjects; Nissen fundoplication corrects the degree of postprandial reflux to a normal range by elevating the LES pressure (11.3 × 1.4 vs. 22.4 ± 1.6 mm Hg; p < 0.001) and length (2.7 ± 0.2 vs. 3.7 ± 0.1 cm; p < 0.001) in our pat

ISSN:0257-2753    

DOI:10.1159/000171427

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171428

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171429

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171430

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171423

出版商:S. Karger AG    

年代:1993

数据来源: Karger