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| 1 | Conventional therapy for moderate to severe inflammatory bowel disease: A systematic literature review显示文摘BACKGROUND Despite the advent of biological drugs, conventional therapy continues to be used in moderate to severe inflammatory bowel disease(MS-IBD). This study hypothesized that as a standard of treatment and the primary alternative to biologics, conventional therapy should present robust effectiveness results in IBD outcomes.AIM To investigate the effectiveness of conventional therapy for MS-IBD.METHODS A systematic review with no time limit was conducted in July 2017 through the Cochrane Collaboration, MEDLINE, and LILACS databases. The inclusion criteria encompassed meta-analyses, systematic reviews, randomized clinical trials, observational and case-control studies concerning conventional therapy in adult patients with MS-IBD, including Crohn's disease(CD) and ulcerative colitis(UC). Corticosteroids(prednisone, hydrocortisone, budesonide, prednisolone,dexamethasone), 5-aminosalicylic acid(5-ASA) derivatives(mesalazine and sulfasalazine) and immunosuppressants [azathioprine(AZA), methotrexate(MTX), mycophenolate, cyclosporine, tacrolimus, 6-mercaptopurine(6-MP)] were considered conventional therapy. The exclusion criteria were sample size below50; narrative reviews; specific subpopulations(e.g., pregnant women,comorbidities); studies on postoperative IBD; and languages other than English,Spanish, French or Portuguese. The primary outcome measures were clinical remission(induction or maintenance), clinical response and mucosal healing. As secondary outcomes, fecal calprotectin, hospitalization, death, and surgeries were analyzed. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation criteria.RESULTS The search strategy identified 1995 citations, of which 27 were considered eligible(7 meta-analyses, 20 individual studies). For induction of clinical remission, four meta-analyses were selected(AZA and 6-MP showed no advantage over placebo,MTX or 5-ASA in CD; MTX showed no statistically significant difference versus placebo, 6-MP, or 5-ASA in UC; tacrolimus was superior to placebo for UC in two meta-analyses). Only one meta-analysis evaluated clinical remission maintenance, showing no statistically significant difference between MTX and placebo, 5-ASA, or 6-MP in UC. AZA and 6-MP had no advantage over placebo in induction of clinical response in CD. Three meta-analyses showed the superiority of tacrolimus vs placebo for induction of clinical response in UC. The clinical response rates for cyclosporine were 41.7% in randomized controlled trials(RCTs) and 55.4% in non-RCTs for UC. For induction of mucosal healing,one meta-analysis showed a favorable rate with tacrolimus versus placebo for UC. For secondary outcomes, no meta-analyses specifically evaluated fecal calprotectin, hospitalization or death. Two meta-analyses were retrieved evaluating colectomy rates for tacrolimus and cyclosporine in UC. Most of the twenty individual studies retrieved contained a low or very low quality of evidence.CONCLUSION High-quality evidence assessing conventional therapy in MS-IBD treatment is scarce, especially for remission maintenance, mucosal healing and fecal calprotectin. | Adérson Omar Mourao Cintra Damiao Matheus Freitas Cardoso de Azevedo Alexandre de Sousa Carlos Marcela Yumi Wada Taciana Valéria Marcolino Silva Flávio de Castro Feitosa | 2019 | World Journal of Gastroenterology2019，25，9： | 13 |
| 2 | Eosinophilic esophagitis: Current concepts in diagnosis and treatment显示文摘Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental)that affects both pediatric and adult patients.Its symptoms,which include heartburn,regurgitation,and esophageal stenosis(with dysphagia being more frequent in eosinophilic esophagitis in young adults and children),are similar to those of gastroesophageal reflux disease,causing delays in diagnosis and treatment.Although endoscopic findings such as furrows,esophageal mucosa trachealization,and whitish exudates may suggest its presence,this diagnosis should be confirmed histologically based on the presence of more than 15 eosinophils per high-power field and the exclusion of other causes of eosinophilia(parasitic infections,hypereosinophilic syndrome,inflammatory bowel disease,among others)for which treatment could be initiated.Currently,the 3“D”s(“Drugs,Diet,and Dilation”)are considered the fundamental components of treatment.The first 2 components,which involve the use of proton pump inhibitors,corticosteroids,immunosuppressants and empirical diets or guided food elimination based on allergy tests,are more useful in the initial phases,whereas endoscopic dilation is reserved for esophageal strictures.Herein,the most important aspects of eosinophilic esophagitis pathophysiology will be reviewed,in addition to evidence for the various treatments. | Andrés Gómez-Aldana Mario Jaramillo-Santos Andrés Delgado Carlos Jaramillo Adán Lúquez-Mindiola | 2019 | World Journal of Gastroenterology2019，25，32： | 2 |
| 3 | Combined protocol for treatment of secondary effect from facial nerve palsy 显示文摘 | Monini S Carlo AD Biagini M | 2011 | Acta Oto Ltryngologica2011，131，： | 1 |
| 4 | Bcl-2 and Bax regulation of apoptosis in germ cells during prenatal oogenesis in the mouse embryo 显示文摘 | Felici MD Carlo AD Pesce M | 1999 | Cell Death Differ1999，6，9： | 1 |
| 5 | Bleeding patterns during continuous estradiol with different sequential progestogens therapy 显示文摘 | Di Carlo C Sammartino A Sardo AD | 2005 | Menopause -the Journal of the North American Menopause Society2005，12，5： | 1 |
| 6 | A proposed mechanism for nitrate and thiocyanate elution of strong-base ion exchange resins loaded with copper and gold cyanocomplexes显示文摘 | Adé lia M O Versiane A L Carlos A S | 2008 | React Funct Polym2008，68，1： | 1 |
| 7 | The meiotic specific synaptonemal complex protein SCP3 is expressed by female and male primordial germ cells of the mouse embryo显示文摘 | Di Carlo AD Travia G De Felici M | 2000 | Int J Dev Biol2000，44，2： | 1 |
| 8 | Increased HIV incidence among men who have sex with men in Rome显示文摘 | Giuliani M Carlo AD Palamara G | 2005 | AIDS2005，19，13： | 1 |
| 9 | A Genetic Screen Implicates miRNA-372 and miRNA-373 As Oncogenes in Testicular Germ Cell Tumors显示文摘 | P. Mathijs Voorhoeve Carlos le Sage Mariette Schrier Ad J.M. Gillis Hans Stoop Remco Nagel Ying-Poi Liu Josyanne van Duijse Jarno Drost Alexander Griekspoor Eitan Zlotorynski Norikazu Yabuta Gabriella De Vita Hiroshi Nojima Leendert H.J. Looijenga Reuven | 2006 | Cell2006，，： | 1 |
| 10 | Conservative treatment by angiographic uterine artery embolization of a 12 week cervical ectopic preghancy显示文摘 | Nappi C Ella AD Carlo CD | 1999 | Hum Reprod1999，14，4： | 1 |
| 11 | Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report显示文摘 | Joshua A. Boyce Amal Assa’ad A. Wesley Burks Stacie M. Jones Hugh A. Sampson Robert A. Wood Marshall Plaut Susan F. Cooper Matthew J. Fenton S. Hasan Arshad Sami L. Bahna Lisa A. Beck Carol Byrd-Bredbenner Carlos A. Camargo Lawrence Eichenfield Glenn T. F | 2011 | Nutrition Research2011，，1： | 1 |
| 12 | Impact of the timing of capsule endoscopy in overt obscure gastrointestinal bleeding on yield and rebleeding rate-is sooner than 14 d advisable?显示文摘AIM To evaluate the impact of the timing of capsule endoscopy(CE) in overt-obscure gastrointestinal bleeding(OGIB). METHODS Retrospective, single-center study, including patients submitted to CE in the setting of overt-OGIB between January 2005 and August 2017. Patients were divided into 3 groups according to the timing of CE(≤ 48 h; 48 h-14 d; ≥ 14 d). The diagnostic and therapeutic yield(DY and TY), the rebleeding rate and the time to rebleed were calculated and compared between groups. The outcomes of patients in whom CE was performed before(≤ 48 h) and after 48 h(> 48 h), and before(< 14 d) and after 14 d(≥ 14 d), were alsocompared.RESULTS One hundred and fifteen patients underwent CE for overt-OGIB. The DY was 80%, TY-46.1% and rebleeding rate-32.2%. At 1 year 17.8% of the patients had rebled. 33.9% of the patients performed CE in the first 48 h, 30.4% between 48 h-14 d and 35.7% after 14 d. The DY was similar between the 3 groups(P = 0.37). In the ≤ 48 h group, the TY was the highest(66.7% vs 40% vs 31.7%, P = 0.005) and the rebleeding rate was the lowest(15.4% vs 34.3% vs 46.3% P = 0.007). The time to rebleed was longer in the ≤ 48 h group when compared to the > 48 h groups(P = 0.03).CONCLUSION Performing CE within 48 h from overt-OGIB is associated to a higher TY and a lower rebleeding rate and longer time to rebleed. | Catarina Gomes Rolando Pinho Adélia Rodrigues Ana Ponte Joana Silva Jaime Pereira Rodrigues Mafalda Sousa Joao Carlos Silva Joao Carvalho | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，4： | 1 |
| 13 | Yield of capsule endoscopy in obscure gastrointestinal bleeding:A comparative study between premenopausal and menopausal women显示文摘AIM To evaluate differences in capsule endoscopy(CE) performed in the setting of obscure gastrointestinal bleeding(OGIB) among premenopausal women(PMW) and menopausal women(MW).METHODS Retrospective, single-center study, including female patients submitted to CE in the setting of OGIB between May 2011 and December 2016. Patients were divided into 2 groups according to age, considering fertile age as ≤ 55 years and postmenopausal age as > 55 years. The diagnostic yield(DY), the rebleeding rate and the time to rebleed were evaluated and compared between groups. Rebleeding was defined as a drop of Hb > 2 g/dL or need for transfusional support or presence of melena/hematochezia.RESULTS A hundred and eighty three female patients underwent CE for OGIB, of whom 30.6%(n = 56) were PMW and 69.4%(n = 127) were MW. The DY was 30.4% in PMW and 63.8% in MW. The most common findings were angiodysplasias in both groups(PMW: 21.4%, MW: 44.9%)(P = 0.003). In PMW, only 1.8% required therapeutic endoscopy. In 17.3% of MW, CE findingsled to additional endoscopic treatment. Rebleeding at 1, 3 and 5 years in PMW was 3.6%, 10.2%, 10.2% and 22.0%, 32.3% and 34.2% in MW. Postmenopausal status was significantly associated with higher DY(P < 0.001), TY(P = 0.003), rebleeding(P = 0.031) and lower time to rebleed(P = 0.001).CONCLUSION PMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower. | Joao Carlos Silva Rolando Pinho Adélia Rodrigues Ana Ponte Jaime Pereira Rodrigues Mafalda Sousa Catarina Gomes Joao Carvalho | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，10： | 0 |
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