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Helsingfors universitet

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Browsing by Subject "TOXIC MEGACOLON"

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    Systematic review of loperamide : No proof of antibiotics being superior to loperamide in treatment of mild/moderate travellers' diarrhoea 
    Laaveri, Tinja; Sterne, Jesper; Rombo, Lars; Kantele, Anu (2016)
    Looking at the worldwide emergency of antimicrobial resistance, international travellers appear to have a central role in spreading the bacteria across the globe. Travellers' diarrhoea (TD) is the most common disease encountered by visitors to the (sub) tropics. Both TD and its treatment with antibiotics have proved significant independent risk factors of colonization by resistant intestinal bacteria while travelling. Travellers should therefore be given preventive advice regarding TD and cautioned about taking antibiotics: mild or moderate TD does not require antibiotics. Logical alternatives are medications with effects on gastrointestinal function, such as loperamide. The present review explores literature on loperamide in treating TD. Adhering to manufacturer's dosage recommendations, loperamide offers a safe and effective alternative for relieving mild and moderate symptoms. Moreover, loperamide taken singly does no predispose to contracting MDR bacteria. Most importantly, we found no proof that would show antibiotics to be significantly more effective than loperamide in treating mild/moderate TD. (C) 2016 The Authors. Published by Elsevier Ltd.


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    WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting 
    De Simone, Belinda; Davies, J; Chouillard, E; Di Saverio, S; Hoentjen, F; Tarasconi, A; Sartelli, M; Biffl, WL; Ansaloni, L; Coccolini, F; Chiarugi, M; De'Angelis, N; Moore, EE; Kluger, Y; Abu-Zidan, F; Sakakushev, B; Coimbra, R; Celentano, V; Wani, I; Pintar, T; Sganga, G; Di Carlo, I; Tartaglia, D; Pikoulis, M; Cardi, M; De Moya, MA; Leppaniemi, A; Kirkpatrick, A; Agnoletti, V; Poggioli, G; Carcoforo, P; Baiocchi, GL; Catena, F (2021)
    Background Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons. Method A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Each expert followed a precise analysis and grading of the studies selected for review. Statements and recommendations were discussed and voted at the Consensus Conference of the 6th World Society of Emergency Surgery held in Nijmegen (The Netherlands) in June 2019. Conclusions Complicated inflammatory bowel disease requires a multidisciplinary approach because of the complexity of this patient group and disease spectrum in the emergency setting, with the aim of obtaining safe surgery with good functional outcomes and a decreasing stoma rate where appropriate.