Paediatric gastrointestinal care

2021 ◽  
pp. 395-404
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
Imperforate Anus ◽  
Congenital Anomalies ◽  
Treatment Options ◽  
Gastrointestinal Diseases ◽  
Toilet Training ◽  
Developmental Issues ◽  
Presenting Symptoms ◽  
Anorectal Atresia

The paediatric gastrointestinal care chapter explores problems with the gastrointestinal tract with a focus on paediatric care. Commonly seen conditions in babies and children are described with the more frequently presenting symptoms listed for the nurse. The occurrence rates of these paediatric conditions are defined and any potential causes described. The investigations that are used to diagnose the condition are explored. Treatment options are also explored with a description of any potential complications. Issues include congenital anomalies, such as imperforate anus, also termed anorectal atresia, when a baby is born without a formed anus. Other gastrointestinal diseases that can affect children include duplication cysts, Hirschsprung’s disease, malrotation, and volvulus. Developmental issues, such as childhood toilet training, are also explored within this chapter. Succinct explorations on the issues related to children and infants can be undertaken within clinical practice by the nurse.

Gall bladder

2021 ◽  
pp. 191-200
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Clinical Practice ◽  
Gall Bladder ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Treatment Options ◽  
Presenting Symptoms ◽  
Preventative Measures ◽  
Common Diseases ◽  
The Common

The gall bladder chapter describes conditions and diseases of the small organ of the gall bladder. The common diseases of the gall bladder are described with the more frequently presenting symptoms listed for the nurse. The occurrence rates of these pancreatic conditions are defined and any potential causes described. The investigations that are used to diagnose the condition are explored. Treatment options or preventative measures are also explored with a description of any potential complications. There are a number of conditions and diseases related to the gall bladder that include primary sclerosing cholangitis and gallstone. Inflammation of the gallbladder, cholecystitis may be acute or chronic. Succinct details related to people with diseases and conditions of the gall bladder are easy to use by the nurse within clinical practice.

Pancreas

2021 ◽  
pp. 181-190
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Practice ◽  
Treatment Options ◽  
Presenting Symptoms ◽  
Preventative Measures ◽  
Common Diseases ◽  
The Common

The pancreas chapter explores the conditions and diseases of the pancreas. The common diseases of the pancreas are described with the identification of the more frequently presenting symptoms. The occurrence rates of these liver conditions are defined and any potential causes documented. The investigations that are used to diagnose the condition are described. Treatment options or preventative measures are also explored with a description of any potential complications. Conditions of the pancreas include pancreatitis which can be either acute or chronic. There is a more in-depth focus on pancreatic cancer. Concise explanations related to people with diseases and conditions of the pancreas will increase knowledge for the nurse that can be used in clinical practice.

Drugs in gastrointestinal care

2021 ◽  
pp. 405-428
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
Side Effects ◽  
Proton Pump Inhibitors ◽  
Nursing Care ◽  
Proton Pump ◽  
Gastrointestinal Diseases ◽  
Ease Of Use ◽  
The Many ◽  
Upper Gastrointestinal

The chapter entitled drugs in gastrointestinal care explores the many drugs that are either used in the care of people with disorders and diseases of the gastrointestinal tract or affect the gut. Medications are often necessary to treat gastrointestinal issues but there may be side effects that should be managed by nurses, Pain might be treated by drugs, such as different types of analgesia; infections are treated by antibiotics, and nausea by antiemetics. Additionally treatment of constipation with the use of laxatives is explored as there are a variety of medications that have dissimilar methods of working. Upper gastrointestinal diseases may be treated by medications, such as proton pump inhibitors. Alternatively, there may be side effects of other drugs that affect the gastrointestinal tract that require nursing care. This chapter is tabulated for ease of use by the nurse in clinical practice, to include the indication for when to use the drug and any side effects.

Mouth, pharynx, oesophagus, and stomach

2021 ◽  
pp. 17-60
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Gastrointestinal Tract ◽  
Treatment Options ◽  
Barrett’S Oesophagus ◽  
Gastric Ulcers ◽  
Initial Part ◽  
Barrett's Oesophagus ◽  
Presenting Symptoms ◽  
Preventative Measures ◽  
Oral Thrush

The mouth, pharynx, oesophagus, and stomach chapter discuss the diseases and conditions that can occur in the initial part of the gastrointestinal tract (GI). These diseases are defined and the possible presenting symptoms listed. The occurrence rates of the conditions within the mouth, pharynx, oesophagus, and stomach are detailed and the potential causes explored. The investigations that might be necessary to diagnose the condition are described. Treatment options or preventative measures are explained with identification of any potential complications. Within the mouth there might be oral thrush; a condition of the oesophagus is Barrett’s oesophagus; and in the stomach there may be gastric ulcers. A succinct description of these conditions and diseases can assist the nurse in managing the care of patients with these problems.

scholarly journals Detoxification therapy for chronic gastrointestinal diseases

2018 ◽  
pp. 50-55
Author(s):  
E. V. Balukova
Keyword(s):  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
Side Effects ◽  
Treatment Effectiveness ◽  
Gastrointestinal Diseases ◽  
Ease Of Use ◽  
Gi Tract ◽  
High Treatment

Enterosorption, as one of the methods of detoxification therapy, has become widespread in clinical practice and is successfully used in the treatment of various diseases of the gastrointestinal tract (GI tract). Safety and ease of use, absence of contraindications and the possibility of combination with other medicines allow individualizing therapeutic tactics, avoiding the side effects of therapy and achieving high treatment effectiveness while reducing its duration.

Gastrointestinal emergencies

2021 ◽  
pp. 429-444
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Abdominal Pain ◽  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
Nursing Care ◽  
Acute Abdominal Pain ◽  
Treatment Options ◽  
Emergency Situations ◽  
Life Threatening

The gastrointestinal emergencies chapter explores a number of emergency situations that can occur with the gastrointestinal tract. These situations can occur quickly and be life-threatening. Nursing care is essential in emergency situations, for example, when there is bleeding in the upper portion of the gut, that is, haematemesis, such as from varices. Treatment can be performed via endoscopy or surgery, for example. Acute abdominal pain may be the result of a perforation or an obstruction within the bowel. A perforation of the bowel might result in peritonitis. These emergencies are explored with consideration of symptoms, causes, investigations, and treatment options. Succinct explanation of gastrointestinal emergencies within this chapter can be used within clinical practice by the nurse.

ANTICYTOKINE ACTIVITY OF THE PROTOZOA BLASTOCYSTIS SPP

2020 ◽  
pp. 44-48
Author(s):  
Bugero N.V. ◽  
Ilyina N.A. ◽  
Aleksandrova S.M.
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Diseases ◽  
Control Group ◽  
Ulcer Disease ◽  
Cytokine Balance ◽  
High Prevalence ◽  
Blastocystis Spp ◽  
High Level ◽  
Eukaryotic Organisms ◽  
High Degree

In addition to the classical pathogens, which are well understood and well identified, new pathogens with the potential to spread epidemiologically are being identified. Some of these little-known organisms are the simplest Blastocystis spp. blastocystostosis. The clinical significance of Blastocystis spp. and its pathogenicity are still under discussion. This parasite belongs to a group of single-celled eukaryotic organisms living in the colon of the human intestine. Blastocystis spp. is known to be found both in people with reduced immune status and in individuals without any clinical manifestation. It has been established that a sufficiently high degree of invasiveness is observed in persons with gastrointestinal tract diseases, dermatosis, allergic reactions, in patients with carriers of the human immunodeficiency virus, etc. Possessing persistence factors, protozoa blastocysts contribute to the inactivation of host defensive mechanisms, providing a stable anthogonistic effect. In recent years, many works have been devoted to the characteristics of the persistent properties of Blastocystis spr., however, individual properties of blastocysts, in particular, anticytokine activity (ACA), have not yet been studied. In this regard, the work studied the anticytokine activity of microorganisms isolated from healthy subjects and patients with gastrointestinal tract diseases. A high prevalence of the studied characteristic in the subjects was shown. The expression of anticytokine activity in the obtained isolates of blastocysts was the highest in the group of persons with gastric ulcer disease, which decreased in the order of duodenal ulcer, chronic cholecystitis, chronic gastritis, etc. The data obtained in this work on the high level of ACA expression in blastocyst isolates obtained from individuals with gastrointestinal diseases as compared with the control group enables to conclude that their exometabolites may influence the local cytokine balance [1], which supports the inflammatory process.

Comprehensive assessment of drug consumption as a basis for pharmacotherapy optimization

2019 ◽  
pp. 22-31
Author(s):  
Olga Vyacheslavovna Zhukova
Keyword(s):  
Clinical Practice ◽  
Treatment Options ◽  
Comprehensive Assessment ◽  
Drug Consumption ◽  
Treatment Standards ◽  
Disease Epidemiology ◽  
Efficacy Analysis ◽  
Epidemiological Monitoring ◽  
Guidelines Development ◽  
Real Clinical Practice

This article describes the rationale for methodology of comprehensive assessment of drug consumption in real clinical practice. The proposed methodology includes three stages: 1) epidemiological monitoring – disease epidemiology assessment; assessment of the role of factors leading to the disease; 2) pharmacoepidemiological monitoring – assessment of pharmacotherapy in real clinical practice; clinical efficacy analysis of drugs; cost-effectiveness analysis; 3) long-term clinical and economical evaluation of various treatment options. Comprehensive assessment of drug consumption should result in optimal pharmacotherapy regimens, decrease of the drug load, increasing of the therapy effectiveness and cost reduction. The scheme of comprehensive assessment of drug consumption is universal and can be used for clinical guidelines development, treatment standards, for the optimal formation of drugs lists at the federal level. Separate stages and sub-steps of an integrated assessment also can be used at the territorial and local levels, medical institution, to optimize pharmacotherapy.

scholarly journals In Pursuit of an Effective Treatment: the Past, Present and Future of Clinical Trials in Inclusion Body Myositis

2021 ◽  
Author(s):  
A. M. Snedden ◽  
J. B. Lilleker ◽  
H. Chinoy
Keyword(s):  
Clinical Practice ◽  
Effective Treatment ◽  
Inclusion Body ◽  
Therapeutic Effect ◽  
Outcome Measures ◽  
Inclusion Body Myositis ◽  
Cytotoxic T Cells ◽  
Treatment Options ◽  
Trial Methodology ◽  
Short Treatment

Abstract Purpose of review No clinical trial in sporadic inclusion body myositis (IBM) thus far has shown a clear and sustained therapeutic effect. We review previous trial methodology, explore why results have not translated into clinical practice, and suggest improvements for future IBM trials. Recent findings Early trials primarily assessed immunosuppressive medications, with no significant clinical responses observed. Many of these studies had methodological issues, including small participant numbers, nonspecific diagnostic criteria, short treatment and/or assessment periods and insensitive outcome measures. Most recent IBM trials have instead focused on nonimmunosuppressive therapies, but there is mounting evidence supporting a primary autoimmune aetiology, including the discovery of immunosuppression-resistant clones of cytotoxic T cells and anti-CN-1A autoantibodies which could potentially be used to stratify patients into different cohorts. The latest trials have had mixed results. For example, bimagrumab, a myostatin blocker, did not affect the 6-min timed walk distance, whereas sirolimus, a promotor of autophagy, did. Larger studies are planned to evaluate the efficacy of sirolimus and arimoclomol. Summary Thus far, no treatment for IBM has demonstrated a definite therapeutic effect, and effective treatment options in clinical practice are lacking. Trial design and ineffective therapies are likely to have contributed to these failures. Identification of potential therapeutic targets should be followed by future studies using a stratified approach and sensitive and relevant outcome measures.

scholarly journals Diagnosis and initial management in psoriatic arthritis: a qualitative study with patients

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Emma Dures ◽  
Clive Bowen ◽  
Mel Brooke ◽  
Jane Lord ◽  
William Tillett ◽  
...  
Keyword(s):  
Functional Limitations ◽  
Treatment Options ◽  
Joint Stiffness ◽  
Self Management ◽  
Easy Access ◽  
Specialist Care ◽  
Structured Interviews ◽  
Psychosocial Burden ◽  
Initial Management ◽  
Presenting Symptoms

Abstract Objectives PsA is an inflammatory condition that can cause pain, fatigue, swelling and joint stiffness. The consequences include impaired physical function, a high psychosocial burden, reduced quality of life and work disability. The presenting symptoms can be non-specific and varied, leading to delays in diagnosis or referral to specialist teams. The aim of this study was to explore patients' experiences of being diagnosed and the initial management of PsA. Methods The study used a qualitative design, with data collected in one-to-one, face-to-face semi-structured interviews. Results Fifteen newly diagnosed patients (<24 months) from three hospital sites in the southwest of England participated. Interviews were transcribed, anonymized and analysed using inductive thematic analysis. The following two main themes with sub-themes represent the data: symptom onset to specialist care: ‘it was the blind leading the blind’ (making sense of symptoms; mis-diagnosis and missed opportunities; and fast and easy access to expertise); and diagnosis as a turning point: ‘having somebody say you've got something wrong with you, I was euphoric’ (validation and reassurance; weighing up treatment options; taking on self-management; and acknowledging loss and change). Conclusion Participants were already dealing with functional limitations and were highly distressed and anxious by the time they received their diagnosis. Physical and mental outcomes could be improved by the implementation of existing psoriasis management guidelines and strategies for earlier referral from primary care to rheumatology and by the development of guidelines on educational, self-management and psychological support provision soon after diagnosis.

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