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At least 1,171 records · Page 65Linked to original sources
PubMed1991

Serum immunomodulatory factors in gastrointestinal diseases. A 30-50-kD serum fraction in Crohn's disease capable of modulating lymphocyte activation.

We tested the hypothesis that serum factors present in Crohn's disease interfere with the process of lymphocyte activation. The mitogen-induced proliferation and the expression of early activation antigens by normal lymphocytes cultured in the presence of either Crohn's disease sera or sera from different controls were evaluated. The mitogen-induced proliferation was significantly impaired in the presence of Crohn's disease sera. These sera markedly inhibited the mitogen-induced interleukin-2 receptor (IL-2R) expression (48% inhibition), while the effect of sera on the expression of the transferrin receptor and the 4F2 antigen was much less pronounced. Diafiltration experiments showed that the inhibitory effect was confined to a 30-50-kD serum fraction. Such a serum property was not related to the patients' disease activity and disappeared after surgical removal of the affected bowel. The capability of inhibiting the mitogen-induced IL-2R expression was not restricted to Crohn's disease and was observed with sera from other inflammatory and neoplastic gastrointestinal disorders. This study indicates that a marked inhibition of the IL-2R is a mechanism underlying the immunosuppressive property of the serum in Crohn's disease and in other gastrointestinal conditions.

Adult↗
PubMed1982

Occurrence of gastric mucosal erosions in association with other upper gastrointestinal diseases, especially peptic ulcer disease, as revealed by elective gastroscopy.

In an elective gastroscopic series of 3837 patients, gastric mucosal erosions were observed in 404 (10.5%) patients, 215 (5.6%) having only erosions without other endoscopic findings in the upper gastrointestinal tract. The male to female ratio was 1.3:1. The number of patients with erosions was highest in the age groups 41-60 years. The patients with erosions were younger than those with peptic ulcer studied during same period. The erosions were located in the distal part of stomach only in 86% of patients. Erosions were observed in 3.5% of patients with stomach resected for peptic ulcer. The positive association with active duodenal ulcer was significant, but there was a negative correlation to gastric cancer, with an almost significant difference compared with patients without gastric erosions randomly selected from the same elective gastroscopic series. The seasonal variation of occurrence resembled more that of gastric than duodenal ulcer.

Adult↗
PubMed2001

[Functional gastrointestinal diseases. More reliable diagnosis using new criteria. Modification required in primary care, however].

The diagnosis of functional gastrointestinal disorders is symptom based. New viewpoints go beyond the old concept of a disease-based reductionistic model, according to which effort is directed toward identifying a single underlying biological etiology, to a more integrated biopsychosocial model of illness. "Rome II: A Multinational Consensus Document on Functional Gastrointestinal Disorders" is an attempt to condense present knowledge into a practical systematic manual. Whereas the ordinary clinician may benefit from it in the understanding of the often confusing accumulation of alternating bowel complaints, its main area of application will be international studies. It will also serve as a basis for taking the concept of functional gastrointestinal disorders further.

Abdomen, Acute↗
PubMed1998

Development of an economic model for the management of upper gastrointestinal disease in primary care. Preliminary findings.

Health economic models for identifying therapeutic options that maximise health benefits from limited healthcare resources are being developed in a number of therapeutic areas. The development of such a model for upper gastrointestinal (UGI) symptoms to support decision-making by primary care clinicians is of particular importance, given the prevalence of this symptomatology. This economic model was based upon the clinical guidelines aimed at improving the management of UGI disorders at the primary care level that were developed by the International Gastro Primary Care Group. This paper discusses the derivation, methodology and results of the economic model developed to assess the resource implications arising from these clinical guidelines. In order to construct the economic model, it was necessary to identify the following: every therapeutic pathway followed by patients resource use along each pathway the probabilities of following alternative pathways. One crucial factor underlying the interpretation of results obtained from any economic model is the time period covered by the model. The model presented here analysed the initial 12-month treatment period of 'new' patients presenting with UGI symptoms. In order to test the implications of a longer term perspective, the model is currently being developed to analyse resource use over a 24-month period. The model demonstrates that utilising the predominant symptom approach to the diagnosis and treatment of patients with UGI disorders appears to provide significant benefits in terms of patient management and effective resource use. This factor, together with the more intensive use of Helicobacter pylori eradication therapy, provides the potential to reduce the cost of drugs for the treatment of UGI disorders by approximately 15% in the UK. A major strength of the model is its adaptability to a wide range of clinical and cost scenarios. Such adaptability enables the model to effectively reflect the potential resource implications in countries exhibiting significantly different levels of cost and patient management. In this manner, the model provides one valuable method by which clinicians can be supported in optimising the management of UGI disorders within current resource constraints.

Cost-Benefit Analysis↗