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Hepatic Encephalopathy: Current Thoughts on Pathophysiology and Management.

PURPOSE OF REVIEW: This review highlights the causes, types and clinical staging of hepatic encephalopathy (HE). Current concepts on the pro … and other toxins by ensuring smooth bowel function and avoiding stagnation with the use of osmotic laxatives like lactulose or lactitol and also reducing the gut microbial load with use of anti-bacterials/bacteriophages like neomycin and rifaximin along with metronidazole. Second, reducing the already generated cerebral edema by use of mannitol and appropr …

[Analysis of clinical features and genetic variants in a Chinese pedigree affected with Spondyloepiphyseal dysplasia type Ehlers-Danlos syndrome due to variants of B3GALT6 gene].

OBJECTIVE: To explore the clinical phenotype and genetic etiology of a child with Ehlers-Danlos syndrome, spondylodysplastic type 2 (EDSSPD2). METHODS: A child who was admitted to the Children's Medical Center of the Affiliated Hospital of Guangdong Medical University in July 2024 for "delayed motor development for 1 and a half year" was selected as the study subject. Clinical data of the child was collected, including medical history, family history, and results of auxiliary examinations. Peripheral venous blood samples were collected from the child and his two brothers and both parents. Gen

Consistency of Organ Geometries during Prostate Radiotherapy with Two Different Bladder and Bowel Regimens.

BACKGROUND: The majority of Ontario cancer centres incorporate bladder and bowel preparation protocols for the treatment of prostate cancer with radical radiotherapy. Differing methods are used to achieve a full bladder and empty rectum for planning and treatment. We compared the effects of two different bladder and bowel preparation regimens on bladder, rectum, and prostate +/- seminal vesicle geometries through a course of radiotherapy. An optimal preparation would achieve reliable spatial arrangements and a high therapeutic ratio. METHODS: This prospective longitudinal study involved 59 pr

Correlation between Constipation Symptoms and Abdominal CT Imaging: A Cross-Sectional Pilot Study.

Evaluation of chronic constipation is important, although it is often difficult to satisfactorily treat due to the complex interplay of factors. This study aimed to determine whether the volume of intraluminal contents and lateral diameter of the colon measured from computed tomography (CT) images were correlated with the symptoms of chronic constipation and stool consistency. Consecutive patients who underwent the Constipation Scoring System (CSS), Bristol Stool Form Scale (BSFS) questionnaires and simple abdominal CT were selected retrospectively. The intestinal tract diameter at each site w

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… Laxative users were those who had taken any laxatives (bulk-forming laxatives, osmotic laxatives, carbohydrate laxatives, irritant cathartic, lubiprostones, linaclotides, elobixibat hydrate, herbal medicine) daily for more than 8 weeks. 2.5. … The correlation between the CT image evaluation and constipation symptoms and various clinical parameters (gender, age, BMI, PPI/PCAB use, laxative use) was examined using Spearman’s correlation coefficient. …

Antitumoral Agent-Induced Constipation: A Systematic Review.

BackgroundConstipation is a common symptom in patients receiving antitumoral treatment. The mechanisms underlying antitumoral agent-induced constipation (ATAIC) are poorly defined. This systematic review aimed to analyze and synthesize the available information related to the prevalence, etiology, and treatment of ATAIC.MethodsA systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was conducted. The review included human studies written in English, French, or Spanish involving patients with cancer and containing information abou

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… The scoping review mentioned high-fiber diets, fluid intake exercises, and laxatives [ 56 ]. The narrative reviews mentioned fluid intake, stool softeners, motility stimulants, neostigmine, and laxatives in general [ 11 , 54 , 55 ]. … General recommendations include the use of non-pharmacological approaches and laxatives. As laxatives, a combination of stool softeners and stimulants is usually needed [ 11 , 55 ]. Laxatives can be administered while the patient is under a chemotherapy regimen. 4.1. …

Comparing the effectiveness, cost-effectiveness and implementation of low-dose oral modified release morphine in people with chronic breathlessness: a synopsis of a RCT and process evaluation.

BACKGROUND: Chronic breathlessness is common and disabling in chronic medical conditions. There is good rationale to use opioids from neuroscience and exercise laboratory studies. OBJECTIVES: We assessed the 56-day effectiveness, cost-consequences and safety of long-acting oral morphine for breathlessness in people with cardio-respiratory diseases or cancer. METHODS: We conducted a parallel-group, randomised, placebo-controlled trial in 11 UK outpatient services, comparing 10-20 mg daily oral morphine with placebo (and blinded laxative) in people with moderate to severe breathlessness, with

Colon Capsule Endoscopy-Measured Colonic Transit Time Is Associated with Frailty in Older Adults.

Background and Objectives: Although the association between frailty and constipation in older adults has attracted growing attention, evidence linking the Clinical Frailty Scale (CFS) to colonic transit time (CTT) remains scarce. In this retrospective study, we examined this association using colon capsule endoscopy (CCE). Materials and Methods: We enrolled 124 older adults (64 men, 60 women) aged ≥ 65 years (mean age 74.6 ± 5.6) who underwent CCE for colorectal polyp screening at Aishinkai Nakae Hospital, Japan, between January 2014 and July 2024. CTT was determined at the time of CCE, and fr

Beyond access: assessing WASH service delivery models in healthcare facilities of North Mecha, Dera, and Farta, Ethiopia.

BACKGROUND: The provision of Water, Sanitation, and Hygiene (WASH) services in Healthcare Facilities (HCFs) necessitates more than just infrastructure; it requires a comprehensive systems approach. Effective WASH service delivery in HCFs involves establishing clear and practical policies and strategies, institutional arrangements and capacity, accountability mechanisms, as well as financing, planning, and monitoring. However, there is currently no well-defined service delivery model for WASH in HCFs in Ethiopia. OBJECTIVE: The objective of this assessment is to gather evidence on the WASH serv

[Risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection for low rectal cancer].

Objective: To evaluate the risk factors of coloanal anastomotic stricture after laparoscopic intersphincteric resection (Lap-ISR) for patients with low rectal cancer. Methods: A retrospective case-control study was performed to collect clinicopathological data from a prospective database (registration number: ChiCTR-ONC-15007506) at the Department of Colorectal Surgery, the Characteristic Medical center of PLA Rocket Force. From June 2011 to August 2018, a total of 144 consecutive patients with low rectal cancer who underwent Lap-ISR were enrolled in the study. Inclusion criteria: (1) reconstr

Current Status of Drug Prescribing among Older Adults with Advanced-stage Cancer Receiving Home Medical Care in Japan: A Nationwide Study.

INTRODUCTION: Balancing preventive and symptomatic medications is crucial to minimizing polypharmacy in older adults with limited life expectancy. This study examined end-of-life medications among older adults with advanced-stage cancer receiving home medical care. METHODS: We conducted a retrospective cohort study using Japan's national claims database between October 2017 and September 2019 and selected adults aged ≥75 years who received comprehensive home medical care services for patients with advanced-stage cancer. We compared prescriptions for preventive and symptomatic medications duri

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… As symptomatic drugs, we examined some frequently prescribed drugs, including acid suppressants, laxatives, analgesics, and hypnotics, based on our previous study in older adults with limited life expectancies receiving home medical care (18) . … Analgesics were most frequently prescribed before the index date (78.7%), followed by laxatives (67.4%) and acid suppressants (65.5%). Table 3. Prescribing of Symptomatic Drugs. Oral drugs, otherwise specified. MRA: mineral corticoid receptor antagonist; NSAID: nonsteroidal anti-inflammatory drug. …

AGA Clinical Practice Update on Pregnancy-Related Gastrointestinal and Liver Disease: Expert Review.

DESCRIPTION: The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update is to review the availabl … ological changes. Treatment options include dietary fiber, lactulose, and polyethylene glycol-based laxatives. BEST PRACTICE ADVICE 6: Elective endoscopic procedures should be deferred until the postpartum period, whereas nonemergent but necessary procedures should ideally be performed in the second trimester. Pregnant patients with cirrhosis should undergo …

Association between bile area in the duodenal bulb and abdominal symptoms: Quantitative analysis using blue laser imaging.

Bile acids are strongly associated with the pathogenesis of functional gastrointestinal diseases. In recent years, blue laser imaging (BLI) endoscopy has emerged as a novel image-enhanced endoscopic method, which illustrates bile as a reddish hue. The present study investigated the factors that affect the area of bile in duodenal bulbs using BLI. For this purpose, patients (356 cases) who underwent upper endoscopy with BLI between April, 2017 and December, 2019, and completed patient background and symptom questionnaires [Constipation Scoring System (CSS), Bristol Stool Form Scale (BSFS) and F

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… In recent years, inhibitors of bile acid transporters ( 8 , 9 ) have been launched as new laxative agents, and the effects of bile on the intestinal tract have attracted considerable attention ( 10 , 11 ). … Patients who did not have a colonoscopy and who were taking laxatives were excluded from the study. Assessments The BMI was calculated by dividing body weight by body height in m 2 (kg/m 2 ). …

Картирование использования высокодозовых или долгосрочных оральных глюкотортикодов и стратегий стероидного спаривания во взрослом возрасте с хроническими условиями: оперативный обзор обзоров.

ЦЕЛЬ: Оральные глюкокортикоиды (ОГК) имеют широкий спектр видов применения и являются эффективными в лечении многочисленных заболеваний. Вместе с тем общепризнано, что на УГК при высоких дозах или в течение длительного периода времени ложится бремя токсичности. Несмотря на применение стероидно-партизационной терапии, по-прежнему прописывают ОВГ для лечения широкого круга иммунных и подстрекательских заболеваний. Мы поставили перед собой цель решить следующие исследовательские вопросы:1) Каковы современные показатели для высоких доз и/или долгосрочных УГК?2) Какие модели использования описаны в

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics.

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, live

Adverse drug reactions and drug-related problems with supportive care medications among the oncological population.

AimThe current study emphasizes the impact of adverse drug reactions (ADRs) and Drug-Related Problems (DRPs) caused by supportive care medications administered with chemotherapy.MethodThis is a longitudinal observational study carried out at the Ramaiah Medical College Hospital in Bengaluru, Karnataka, India, at the Department of Oncology. The data was recorded using a specifically created data collecting form. Based on the PCNE (Pharmaceutical Care Network Europe), DRPs are identified. The WHO probability scale, Modified Hartwig and Siegel for ADR severity assessment, Naranjo's algorithm for

MyPainPal, a Novel mHealth App to Improve Pain in Patients With Advanced Cancer: Single-Arm Pilot Study.

BackgroundPain is common among patients with advanced cancer and is often inadequately controlled. Opioids are central to treatment; yet, self-management is challenging, and clinicians lack scalable tools to monitor and support patients between visits.ObjectiveThis study aimed to evaluate the feasibility and acceptability of MyPainPal (Dana-Faber Cancer Institute), a novel mobile health app designed to optimize cancer pain management. MyPainPal combines daily surveys assessing symptoms and analgesic use, algorithmic self-management support, tailored psychoeducation, and clinician monitoring. S

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… To enable self-management support for opioid-induced constipation, participants reported constipation severity, days since their last bowel movement, and doses of laxatives taken. … A few patients relied on the app for laxative titration instructions; however, many patients did not notice this advice as it required scrolling down to the end of the symptom summary screen. …

Нейрогенная желудочно-кишечная, мочевая и сексуальная дисфункция при множественном склерозе: многодисциплинарная основа для клинической практики.

Нейрогенные желудочно-кишечные, мочевые и сексуальные симптомы широко распространены у людей с множественным склерозом и существенно ухудшают качество жизни, повседневное функционирование и психосоциальное благополучие. Несмотря на их частотность и клиническую актуальность, управление по-прежнему носит разрозненный характер по различным специальностям, тесная взаимосвязь между этими симптомами зачастую игнорируется, а у клинических работников отсутствует прагматическая основа, адаптированная к различным условиям здравоохранения. Этот обзор преобразует нынешние данные в прагматичную модель уход

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… Evidence from multiple randomized controlled trials (RCTs) lasting up to 6 months supports the use of osmotic laxatives as the preferred first-line pharmacological therapy. 16 Macrogol is preferred over lactulose due to less frequent blowing. 17 If after some days of laxative therapy no effect is seen … Glycerine suppositories are an add-on option in patients with DD who cannot benefit from biofeedback therapy (BT) or do not benefit from laxatives and prokinetic therapy. As a last resort, transanal irrigation (TAI) can be used. …

US Life Expectancy and Increasing Mortality Rates: An Analysis of the Crisis.

UNLABELLED: Policy Points US life expectancy is shorter than in other high-income countries and the gap has widened dramatically over time, driven in particular by rising mortality rates that threaten the probability that youth can survive to middle age, or even adulthood. Policy priorities to address this crisis include efforts to address the proximal causes of rising mortality, such as poor diet, drug overdoses, problem drinking, homicide, suicide, and chronic diseases such as cardiometabolic, neurologic and genitourinary diseases, among others. Meaningful progress in closing the gap with ot

Final report on the safety assessment of Ricinus Communis (Castor) Seed Oil, Hydrogenated Castor Oil, Glyceryl Ricinoleate, Glyceryl Ricinoleate SE, Ricinoleic Acid, Potassium Ricinoleate, Sodium Ricinoleate, Zinc Ricinoleate, Cetyl Ricinoleate, Ethyl Ricinoleate, Glycol Ricinoleate, Isopropyl Ricinoleate, Methyl Ricinoleate, and Octyldodecyl Ricinoleate.

The oil derived from the seed of the Ricinus communis plant and its primary constituent, Ricinoleic Acid, along with certain of its salts and esters function primarily as skin-conditioning agents, emulsion stabilizers, and surfactants in cosmetics, although other functions are described. Ricinus Communis (Castor) Seed Oil is the naming convention for castor oil used in cosmetics. It is produced by cold pressing the seeds and subsequent clarification of the oil by heat. Castor oil does not contain ricin because ricin does not partition into the oil. Castor oil and Glyceryl Ricinoleate absorb ul

Case report and comprehensive literature review: A rare instance of lipoid pneumonia.

RATIONALE: This case report elucidates the diagnostic challenges and natural progression of lipoid pneumonia (LP), a rare pulmonary condition, highlighting the critical importance of long-term monitoring. PATIENT CONCERNS: An 82-year-old female presented with a 2-year history of chronic cough and an acute exacerbation. DIAGNOSES: Initial diagnosis was severe pneumonia. Definitive diagnosis of LP was confirmed by computed tomography -guided lung biopsy, which revealed lipid-laden macrophages. INTERVENTIONS: Suspected lipid exposure was discontinued, and supportive conservative care was provi

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… She also reported chronic abdominal distension with intermittent use of oily laxatives. On May 4, 2024, the patient sought medical attention for a 2-year history of cough that had worsened over half a month, with occasional sputum production. … neuromuscular diseases causing swallowing dysfunction. [ 6 ] In this particular case, the patient had multiple underlying conditions that served as risk factors, including preexisting swallowing dysfunction with occasional choking during meals, chronic abdominal distension, and long-term use of oily laxatives …