41,899 results match your criteria Nihon rinsho. Japanese journal of clinical medicine[Journal]


Paroxysmal limb intolerable pain (infantile pain episodes associated with novel Nav1.9 mutations in familial episodic pain syndrome).

Nihon Rinsho 2017 04;75(4):641-651

Painful peripheral neuropathy has been correlated with various voltage-gated sodium channel mutations in sensory neurons. Recently Navl.9, a voltage-gated sodium channel sub- type, has been established as a genetic influence for certain peripheral pain syndromes. Read More

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Continence care with high QOL(quality of life) for the aged.

Nihon Rinsho 2017 04;75(4):636-640

At the time to select methods for continence care, doctors should consider not only scien- tific factors but also quality of life. Functions of lower urinary tract are storage and voiding. Urine is waste of human body, so it is essential to void urine perfectly in a view point of to keep homeostasis. Read More

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April 2017
6 Reads

Development of continence care system for the elderly in a community.

Authors:
Momokazu Gotoh

Nihon Rinsho 2017 04;75(4):631-635

The majority of fragile elderly individuals, such as the elderly in institutions for the elderly and those in home care use diaper or indwelling urethral catheters without careful considera- tion. Lower urinary tract dysfunction is hardly life threatening, but it impairs the dignity and quality of life of individuals. Inappropriate urinary management of elderly individuals leads to adverse changes in immobilization and dementia, and would ultimately render the disease untreatable. Read More

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April 2017
6 Reads

A fact and problems of the anticancer chemotherapy for elderly patients.

Authors:
Isao Hara

Nihon Rinsho 2017 04;75(4):626-630

Since the rate of elderly patients in cancer death is continuously increasing, elderly pa- tients are not special, but ordinary population in daily clinical settings. Geriatric assessment (GA) is recommended to evaluate elderly patients when they undergo anticancer chemother- apy. Geriatric 8 (G8) is an excellent screening tool to evaluate physical and mental function of elderly patients. Read More

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Current multidisciplinary approaches for metastatic prostate cancer.

Nihon Rinsho 2017 04;75(4):620-625

Prostate cancer incidences in most Asian populations have rapidly increased, and prostate cancer ranks as the highest incidence of male cancer in Japan since 2015. Androgen depriva- tion therapy (ADT) remains the main first-line treatment for patients with metastatic prostate cancer (mPCa). However, treatment benefits last for 3-5 years when disease transforms into metastatic castration-resistant prostate cancer (mCRPC). Read More

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Chemotherapy against bladder cancer in geriatric patients.

Nihon Rinsho 2017 04;75(4):615-619

The number of geriatric bladder cancer patients is now increasing in spite of little is known regarding the safety and efficacy of standard treatment for the patients due to luck of data in geriatric patients. Although they should be treated by modified standard treatment adjusted for their deteriorated physical activity, such treatment regimens are not established. Bladder preservation therapy could be recommended for geriatric patients with invasive bladder can- cer, which shows comparable survival benefit with radical cystectomy. Read More

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Surgical treatment of bladder cancer in the geriatric patients.

Nihon Rinsho 2017 04;75(4):611-614

As bladder cancer is an age-related disease and an increase in patients with MIBC seems inevitable because of the aging population in Japan, muscle-invasive bladder cancer (MIBC) care in the elderly is likely to become a very common problem in daily practice. The gold standard for patients with MIBC is radical cystectomy (RC). However, elderly patients present with several comorbidities, and the geriatric patients with MIBC were not given po- tentially curative treatments, including RC. Read More

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Pathogenesis and treatment of upper urinary tract cancer.

Authors:
Yasuyuki Sakai

Nihon Rinsho 2017 04;75(4):607-610

Upper urinary tract cancer originates in the renal pelvis or ureter and is relatively uncom- mon. The predilection age is 65 to 79 years in Japan. Currently, a diagnosis is usually con- firmed using computed tomography urography. Read More

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Drug therapy for renal cell carcinoma in the elderly.

Nihon Rinsho 2017 04;75(4):602-606

The incidence of renal cell carcinoma (RCC) peaks between 60 and 70 years, and > 25% of newly diagnosed patients are > 75 years. However, clinical trials for the evaluation of drug therapy for metastatic RCC (mRCC) have generally under-represented the actual proportion of elderly patients in the general population of mRCC patients; therefore, limited data remain available with respect to the efficacy as well as safety of drug therapy for elderly mRCC pa- tients. In this review, therefore, we attempted to summarize the current status of drug ther- apy for mRCC in the elderly based on both the available findings as well as our experience, and to discuss the future prospect of this therapy considering characteristics specific to eld- erly mRCC patients. Read More

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Ablation therapy for renal cell cancer of elderly patients.

Nihon Rinsho 2017 04;75(4):597-601

Japanese Urological Association reported that 3,648 patients of renal cell carcinoma were diagnosed in 2007 from 340 institutions and 70 years old or more accounted for 35.5% of pa- tients and 8.3% were more than 80 years old. Read More

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April 2017
8 Reads

Surgical therapy for the elderly patients with renal cell carcinoma.

Nihon Rinsho 2017 04;75(4):593-596

It is controversial whether the definitive therapies are really required to the elderly with kidney cancer. This issue may be complicated because many factors, such as the definition of the elderly, function in daily life, tumor size, selected therapy, influence the decision of renal tumor management. Herein we reviewed the role of the various therapeutic options for the non-advanced renal tumors among the elderly. Read More

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LOH (late-onset hypogonadism) syndrome.

Nihon Rinsho 2017 04;75(4):588-592

Testosterone deficiency has recently drawn wide attention due to the high prevalence of hypo-gonadal symptoms in the aging male population. A number of studies have reported the beneficial effects of testosterone replacement therapy for men with late-onset hypogonadism (LOH) syndrome. Based on the study evaluating the age distribution of serum testosterone concentration, serum free testosterone less than 8. Read More

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Erectile dysfunction.

Authors:
Atsushi Nagai

Nihon Rinsho 2017 04;75(4):584-587

Aging is the biggest risk factor of erectile dysfunction (ED). Seventy-one percent of Japanese men aged 70 to 79 years reported suffering from ED. Blood vessels and nerves related to erection are damaged by various risk factors as well as histological change in a corpus cavernosum penis, decreased testosterone level, and various complexed factors. Read More

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Urinary incontinence.

Nihon Rinsho 2017 04;75(4):579-583

Urinary incontinence (UT) has considerable impacts on quality of life (QOL) and the num- ber of patients of it increases by age. Classifying UT based on the pathophysiology, it includes stress urinary incontinence (SUI), urgency urinary incontinence (UUI), overflow incontinence and functional urinary incontinence. SUI alone is the most common among female with UI, followed by mixed urinary incontinence of SUI and UUI, and UUI alone. Read More

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Overactive bladder.

Nihon Rinsho 2017 04;75(4):573-578

Overactive bladder (OAB) is a storage symptom complex that includes urinary urgency with or without urge incontinence, urinary frequency and nocturia. OAB is common symp- tom complex and its morbidity is high and increased with age. Although many factors cause OAB, we can classify them as neurogenic or non-neurogenic. Read More

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April 2017
1 Read

Diagnosis and treatment of benign prostatic hyperplasia in the elderly.

Nihon Rinsho 2017 04;75(4):567-572

Elderly people are at a high risk of experiencing problems with drug therapy due to age- related changes in the body, as well as exposure to many medications owing to multiple health problems. Medication-related adverse events are common amongst the elderly. Pharmacotherapy for benign prostatic hyperplasia or overactive bladder can generally im- prove lower urinary tract symptoms, whilst also improving the quality of life. Read More

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April 2017
13 Reads

Urogenital infections.

Authors:
Mitsuru Yasuda

Nihon Rinsho 2017 04;75(4):558-566

Complicated pyelonephritis, acute epididymitis and acute prostatitis are febrile urogenital infections. Because the elderly person often has an underlying disease, urogenital tract infec- tions of the elderly persons are complicated urinary tract infections in most cases. However, in the elderly people, clear findings that are characteristic of urogenital infections are not often obtained in the physical examination. Read More

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April 2017
7 Reads

Urinary disturbance in elder patients -Characteristic and problems based on the sex-.

Nihon Rinsho 2017 04;75(4):553-557

In the elderly person, various urinary symptoms are developed regardless of man and woman by a physical change with the aging. In elder men, we often recognize the progress of the urinary disturbance with the progress of benign prostatic hyperplasia (BPH). Based on the recent increase of prostate cancer patients, the number of elder patients treated with radi- cal prostatectomy or radiotherapy for prostate is increasing. Read More

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Benefits and controversies points of expanding minimum invasive surgery.

Nihon Rinsho 2017 04;75(4):548-552

Change by aging, which varies among individuals, influences physical and mental condi- tion, and social activity. Especially, illness accelerates the decreases of them in old adults. Surgical treatment for elderly patients might put a burden on their conditions and decrease activity of daily living if patients had adverse event and prolonged hospitalization. Read More

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April 2017
2 Reads

Urological surgery in elderly and the perioperative management.

Nihon Rinsho 2017 04;75(4):543-547

Perioperative delirium and depression are characteristic of in elderly patients undergoing urological operation. The treatment for urological disease is stagnant, exchanged or inter- rupted by these complications. Furthermore, these complications may course to other more complications. Read More

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April 2017
22 Reads

Ageing-related bladder functional and biological changes.

Authors:
Naoki Aizawa

Nihon Rinsho 2017 04;75(4):539-542

One of the major global demographic trends is the rapid ageing population, and the num- ber of people with ageing-related diseases has been increasing. In the urological field, ageing-related lower urinary tract symptoms (LUTS), especially detrusor hyperactivity with impaired contractility (DHIC), are commonly observed among elderly patients. However, such ageing-related LUTS and their backgrounds widely vary by individual. Read More

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Lower urinary tract dysfunction and comprehensive geriatric assessment in the elderly.

Authors:
Masaki Yoshida

Nihon Rinsho 2017 04;75(4):533-538

In the elderly, various factors except the urological abnormality of lower urinary tracts often participate in the lower urinary tract dysfunction. The elderly person often causes the change of the general systemic function (basic ability for daily living activity, a cognitive func- tion, emotion or feeling). In addition, the condition such as frailty and sarcopenia are ob- served in considerably high rate in the elderly. Read More

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April 2017
1 Read

Epidemiology of urologic diseases in the aging population.

Nihon Rinsho 2017 04;75(4):527-532

Japan is an aging society. In general, an elderly population has urological diseases. Therefore, to understand the epidemiology of urological diseases is clinically very important. Read More

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Present status and future prospect of urological diseases in the elderly.

Authors:
Yukio Homma

Nihon Rinsho 2017 04;75(4):520-525

Most urological diseases are common in the elderly. Indolent cancer is a clinical dilemma in management of renal and prostate cancers, which are often incidentally found in the eld- erly. Bladder cancer usually needs urological intervention somehow even in highly aged pa- tients to prevent massive hematuria and clot retention. Read More

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April 2017
6 Reads

Rubinstein-Taybi syndrome.

Authors:
Rika Kosaki

Nihon Rinsho 2017 Mar;75(3):498-503

Rubinstein-Taybi syndrome (RTS) is characterized by moderate to severe intellectual disability, distinctive facial features, and broad thumbs and great toes. RTS is caused by haploinsufficiency of CREBBP or EP300 gene. Read More

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Fecal microbiota transplantation.

Nihon Rinsho 2017 Mar;75(3):492-497

Various strains of microorganisms inhabit the human intestinal tract, and disturbance of intestinal flora, dysbiosis, is thought to be pathogenesis of various diseases. Inducing symbiosis of intestinal flora has therapeutic potential for gastrointestinal diseases, but there are limited therapeutic options including probiotics.'Previous reports suggested that fecal microbiota transplantation (FMT) was a very useful choice in treatment for recurrent Clostridium difficile infection. Read More

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Clinical development of new drugs for inflammatory bowel disease.

Nihon Rinsho 2017 Mar;75(3):488-491

Following the success of anti-TNF antibody reagents, the development of new therapies for inflammatory bowel disease is mainly based on molecular targeted drugs. Among them, the effectiveness of therapeutic agents targeting lymphocyte migration and proinflammatory cytokines has been successful. The anti-a4β7 integrin antibody, vedolizumab, has already been used in the treatment of both ulcerative colitis and Crohn's disease in Europe and the United States. Read More

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Genetics of inflammatory bowel disease in Japanese.

Nihon Rinsho 2017 Mar;75(3):482-487

Several genetic studies have identified >200 susceptibility loci for inflammatory bowel disease (IBD), mostly shared between ulcerative colitis (UC) and Crohn's disease (CD). By analyzing the genetic background associated with disease sub-phenotypes, colonic Crohn's disease located intermediate between Crohn's disease with ileal involvement and UC. However, these loci were analyzed mainly in Caucasian IBD, less is known about IBD genetics in other population including Japanese. Read More

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March 2017
7 Reads

Prospects for stem cell-based mucosal regeneration therapy in inflammatory bowel disease.

Nihon Rinsho 2017 Mar;75(3):477-481

Recent advances in the treatment of inflammatory bowel diseases has raised its therapeutic goal up to completely repairing the damaged intestinal tissue and achieve "mucosal healing". To improve and further facilitate the tissue repair process in inflammatory bowel disease patients, stem cell based therapy using mesenchymal stem cells is under development. Also, transplantation of ex-vivo cultured intestinal stem cells is another regenerative therapy that may become an alternative choice to treat refractory ulcers in inflammatory bowel disease patients. Read More

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Colitis-associated cancer in inflammatory bowel disease and effective endoscopic surveillance programs.

Nihon Rinsho 2017 Mar;75(3):471-476

Patients with longstanding inflammatory bowel disease, such as ulcerative colitis and Crohn's disease are well known to have at high risk of developing colorectal cancer. Oxidative stress-induced DNA damage from chronic inflammation is considered to cause various genomic and epigenomic changes in the intestinal mucosa (e.g. Read More

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Osteoporosis in inflammatory bowel disease.

Authors:
Minoru Matsuura

Nihon Rinsho 2017 Mar;75(3):466-470

Patients with inflammatory bowel disease (IBD) are at increased risk for osteoporosis and fracture. This is considered to be relevant to IBD-related risk factors, including intestinal inflammation, low nutrient status and the use of corticosteroids, in addition to general risk factors, such as age, gender and BMI et al. A recent meta-analysis suggests that bisphosphonate is effective and safe for the treatment of low bone mineral density and reduce risk of vertebral fractures in patients with IBD. Read More

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Hepatitis B virus reactivation in inflammatory bowel diseases.

Nihon Rinsho 2017 Mar;75(3):461-465

Immunosuppressive therapy is a standard treatment for inflammatory bowel disease. However, immunosuppressive therapy is associated with severe side effects such as serious infection. In particular, hepatitis B virus (HBV) reactivation is a concern because it often leads to severe or fatal hepatitis. Read More

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March 2017
1 Read

Venous thromboembolism.

Authors:
Mikihiro Fujiya

Nihon Rinsho 2017 Mar;75(3):455-460

Venous thromboembolism frequently occurs in patients with inflammatory bowel diseases (IBD) in western as well as Japan because of the alterations of congealing fibrinogenolysis system due to the refractory enteritis. Aging, disease activity, colorectal lesions, admission, central venous catheter and operations are risk factors for the development of venous thromboembolism. Aggressive treatments including preventive and therapeutic anti-coagulation are recommended in western countries. Read More

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March 2017
1 Read

Recent advances in IgG4-related disease, autoimmune pancreatitis and sclerosing cholangitis.

Nihon Rinsho 2017 Mar;75(3):450-454

Recently, a novel concept of IgG4-related disease (IgG4-RD), which shows increased serum IgG4/IgE levels, abundant infiltration of IgG4+plasmacytes and lymphocytes, fibrosis, and steroid responsiveness, has been worldwide accepted. The international consensus diagnostic criteria suggested the existence of two subtypes of autoimmune pancreatitis (AIP) : type 1 related with IgG4, and type 2 related with a granulocytic epithelial lesion. Before the IgG4-era, most of IgG4-SC cases were misdiagnosed as primary sclerosing cholangitis (PSC). Read More

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Clinical features of inflammatory bowel disease of the elderly onset.

Nihon Rinsho 2017 Mar;75(3):445-449

The incidence and prevalence of inflammatory bowel disease (IBD) is increasing globally. IBD of the elderly is common with prevalence rates. Genetical background involve less in the pathophysiology older-onset of IBD. Read More

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Management of children and adolescents with inflammatory bowel disease.

Authors:
Atsushi Yoden

Nihon Rinsho 2017 Mar;75(3):437-444

Crohn's disease and ulcerative colitis in children have more extensive disease with more severe disease course, more earlier progression of disease, and more longer disease course than adult IBD. Children with IBD often require rapid treatment escalation both for induction and maintenance of remission, due to more severe disease activity. The goals of treatment of IBD in children and adolescents are to eliminate symptoms with minimal complications, avoid drug-induced short- and long-term adverse effects, optimize growth and nutrition, decrease the psychosocial burden of the disease with psychosocial support, and restore quality of life, not only at the diagnosis, also during treatment. Read More

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Surgical treatment for ulcerative colitis.

Nihon Rinsho 2017 Mar;75(3):433-436

Operative procedures for ulcerative colitis have become standardized and its is considered unlikely that they will undergo major modifications in the future. Several studies have shown that the numbers of individuals indicated for surgery for colitis- associated cancer/dysplasia are increasing. However, for elderly patients, the procedure and timing of surgery remain controversial, while it is important to keep in mind postoperative quality of life factors when selecting the procedure in those cases. Read More

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March 2017
1 Read

Surgical treatment for Crohn's disease.

Nihon Rinsho 2017 Mar;75(3):426-432

Surgery has important role in the management for Crohn's disease, although medical treatment had been developed in recent years. Surgical indications are as follows, massive bleeding, perforation, cancer, abscess, stenosis with obstruction, internal and external fistulas, severe anorectal disease, and medical failure. The principle of surgery is a minimal resection of intestine responsible for uncontrolled symptoms and repair of involved organs such as intestine, urinary bladder and abdominal wall. Read More

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Cytapheresis.

Nihon Rinsho 2017 Mar;75(3):419-425

In the inflammatory bowel disease (IBD) therapeutic settings, leukocytapheresis (LCAP), and Adsorptive Granulocyte/Monocyte Apheresis (GMA) are currently the two major cytapheresis (CAP) strategies approved and are applied to treat patients with IBD, which has become refractory to conventional pharmacological intervention. Further, based on our recently concluded prospective multi-centre studies, we can now report on the therapeutic efficacy, safety and demographic factors, which identify ulcerative colitis (UC) patients as responders, or otherwise as non-responders to CAP. Further, in Crohn's disease (CD) patients, hitherto studies have not identified CAP-responder features. Read More

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March 2017
3 Reads

Enteral nutrition and dietary interventions.

Nihon Rinsho 2017 Mar;75(3):414-418

Currently, various dietary interventions or supplements, including probiotics and prebiotics, are available for patients with Crohn's disease. Among these interventions or supplements, there is nothing showing significant efficacy. Although the evidence level is not high, the available data suggest that enteral nutrition is effective in both active and quiescent Crohn's disease. Read More

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March 2017
1 Read

Immunomodulator and calcineurin inhibitors on inflammatory bowel disease.

Nihon Rinsho 2017 Mar;75(3):408-413

Immunomodulator (thiopurines) and calcineurin inhibitors (cyclosporine, tacrolimus) have been used in IBD treatment. Thiopurines such as azathioprine and 6-mercaptopur- ine are used in steroid refractory and steroid dependent UC patients. They are also concomitant used both in CD and UC with other drugs including anti-TNFa monoclonal Ab mainly as maintenance therapy. Read More

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March 2017
6 Reads

Biologic drugs for inflammatory bowel disease.

Nihon Rinsho 2017 Mar;75(3):403-407

Biologics have become widely used as an innovative therapy for the management of inflammatory bowel disease (IBD) such as Crohn's disease, ulcerative colitis and intestinal Behcet's disease. Tumor necrosis factor (TNF)-a is one of the crucial mediators in these diseases, and biological therapies targeting TNF-a are efficacious for the management of IBD refractory to conventional therapies. Anti TNF-a monoclonal antibodies such as infliximab and adalimumab have been shown to have efficacy in IBD. Read More

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March 2017
8 Reads

Steroid therapy for inflammatory bowel disease.

Authors:
Masayuki Saruta

Nihon Rinsho 2017 Mar;75(3):398-402

In inflammatory bowel disease (IBD) as represented by ulcerative colitis (UC) and Crohn's disease (CD), UC is characterized by the diffuse inflammation from rectum and the resulting frequent diarrhea and bloody stool, and CD is characterized by scattered inflammation that may affect any part of the gastrointestinal tract from mouth to anus. Both diseases include diarrhea and abdominal cramping or pain, therefore IBD patients lose the quality of life coclusively. In general, salazosulfapyridine and 5-acetylsalicylic acid (5-ASA) are baseline drugs for IBD, but sometimes these drugs are insufficient to suppress their inflammation. Read More

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5-Aminosalicylic acid.

Nihon Rinsho 2017 Mar;75(3):392-397

Despite the emergence of new biological therapies that aim for mucosal healing as a new therapeutic target, the importance of 5-ASA formulations in the standard treatment for inflammatory bowel diseases, particularly ulcerative colitis, remains unchanged. With a growing number of patients suffering from inflammatory bowel diseases in Japan, general physicians are also increasingly prescribing 5-ASA formulations. In order to obtain the maximum efficacy of 5-ASA formulations when treating inflammatory bowel diseases, it is essential that the dosage and administration are appropriate. Read More

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March 2017
4 Reads

Imaging (X-ray - CT - MRI - ultrasound).

Nihon Rinsho 2017 Mar;75(3):387-391

Inflammatory bowel diseases (IBD) require evaluation diagnosis, disease course, location, activity and severity. Endoscopy is well established modality for IBD evaluation but sometimes it is invasive and has some risks. Radiological imaging techniques are less invasive and complementary to endoscopy. Read More

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March 2017
11 Reads

Endoscopy for inflammatory bowel disese.

Nihon Rinsho 2017 Mar;75(3):380-385

Endoscopy is needed to make a diagnosis for ulcerative colitis (UC) and Crohn's disease (CD). Endoscopy is also useful to make a treatment decision by assessing the severity and extension of inflammations. The endoscopic severity is associated with the long-term prognosis of UC and CD, thus, mucosal healing has raised as treatment goal. Read More

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March 2017
7 Reads

History taking, Biochemical examination, Bacteriological examination.

Nihon Rinsho 2017 Mar;75(3):376-379

In the diagnosis of inflammatory bowel disease (IBD), careful history taking based upon available epidemiological data, along with judicious use of biochemical and bacteriological examination is the most powerful and cost-effective technology, particularly to rule out irritable bowel syndrome (IBS). We also have to be careful in evaluating symptomatic IBD patients looking for exacerbating factors such as Clostridium difficile infection, use of NSAIDs, and non-adherence which is revealed only by frank discussion. Read More

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March 2017
1 Read

The diagnostic criteria and differential diagnosis of IBD.

Authors:
Yasuo Suzuki

Nihon Rinsho 2017 Mar;75(3):371-375

Adequate therapy can be done to patients with inflammatory bowel disease just after accurate diagnosis being done speedy. It is necessary to confirm typical symptoms and typical by imaging and to fit them to diagnostic criteria when a patient is suspected to be IBD. But we have to care about that typical clinical symptoms and typical imaging are not always specific to IBD, other intestinal disease than IBD can present such as symptoms and imaging not rarely. Read More

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Pathogenesis of inflammatory bowel disease.

Nihon Rinsho 2017 Mar;75(3):364-369

The causes of IBD (inflammatory bowel disease), ulcerative colitis and Crohn's disease, have not been elucidated. It is thought that the pathogenesis involves genetic predisposition, environmental factors and host immune response to food antigens and microbiota. Most of IBD susceptiblity genes are related to function of immune cells, maintenance of homeostasis of epithelial cells, autophagy, ER stress and so on. Read More

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Definition and epidemiology of inflammatory bowel disease.

Nihon Rinsho 2017 Mar;75(3):357-363

Inflammatory bowel disease (IBD) includes two major disorders: ulcerative colitis (UC) and Crohn's disease (CD). Both usually involve severe diarrhea, pain, fatigue and weight loss. IBD can be debilitating and sometimes leads to life-threatening complications. Read More

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