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This book is the proceedings of Falk Symposium 151 on 'Emerging
Issues in Inflammatory Bowel Diseases', held in Sydney, Australia,
on 24-25 March 2006, the first symposium of its kind both in the
southern hemisphere and in the Asia--Pacific region. All
contributors are leaders in their field of IBD across a wide
spectrum of geographical regions and ethnicity. The book presents
the first major text where East meets West in IBD. The major issues
of concern in the regions where IBD is a relatively common disease
include the role of genetic and environmental factors in
pathogenesis and disease expression, the application of
sophisticated diagnostic tools, and the best use of biological
agents in therapy.
The first gene responsible for Crohn's disease has now been
identified and the pathophysiological understanding of inflammatory
bowel disease as well as its practical treatment have made much
progress in recent years. Thus it is obviously important to
consider the targets and the aims of treatment in context. The Falk
Symposium No. 131 (Part II of the Gastroenterology Week Freiburg
2002), held in October 2002 in Freiburg, Germany, in its first part
was dedicated to newly defined and partly alternative therapeutic
targets. In addition, an attempt was made to learn from experts
from other fields such as pneumology or dermatology. The second
part was dedicated to the aims of treatment in daily practice.
Aside from general treatment, aims such as amelioration of
symptoms, pre-conditions of treatment, the view of the patients,
and aspects of life quality were dealt with. This volume is the
proceedings of the symposium and is important reading for both
clinicians and basic scientists.
The aetiology of the chronic inflammatory bowel diseases - Crohn's
disease and ulcerative colitis - is still enigmatic. The
therapeutic approach has therefore traditionally focused on
anti-inflammatory principles, including corticosteroids and
aminosalicylates. Since a significant proportion of patients is
steroid-dependent or refractory and because of the problematic
side-effects of long-term systemic steroids, active
immunosuppression has gained acceptance in the field. The classical
immunosuppressants azathioprine and 6-mercaptopurine have long been
evidence-based in IBD, but underused. Recently, methotrexate and
cyclosporine have also been proven to be effective in certain
situations. Newer drugs like tacrolimus, mycophenolate and others
may be similarly useful but their potential is still unclear.
Finally, the immune modifiers including IL-10 and TNF-antibodies
have been successfully subjected to controlled trials. Other
experimental drugs discussed in this book are on the horizon. This
volume is the Proceedings of Falk Symposium 119 held in
Freiburg-im-Breisgau, Germany, October 3-4, 2000, and covers
systematically the field of immunosuppression in inflammatory bowel
diseases. It is hoped that it will further the prudent use of these
drugs in the proper clinical situations by increasing our
understanding of both the mechanisms of action and the clinical
benefit to the patient.
The gastrointestinal tract has a number of unique features. Its
extensive surface is formed by a single layer of rapidly renewing
cells, the intestinal epithelial cells. These cells are in contact
with a number of other cell populations, including the largest part
of the immune system, and with an excessive luminal antigen load,
including vast numbers of bacteria. Furthermore two more organs,
namely liver and pancreas, are part of the system. The rapid
renewal of the epithelial layer, the interactions of different cell
types, and the balance between cell proliferation and death, have
been fascinating subjects of studies in recent years. Much has been
learned, and cytokines have emerged as important mediators for all
these interactions and homeostatic systems. This book, the
proceedings of the Falk Symposium 113 on `Cytokines and Cell
Homeostasis in the Gastrointestinal Tract', held in Regensburg,
Germany, 16-18 September 1999, provides a forum for basic
scientists and interested clinicians to exchange ideas, to discuss
concepts and to plan further studies.
Ulcerative colitis and Crohn's disease remain a great therapeutic
challenge to the medical community. In recent years knowledge about
the pathogenesis of these diseases has progressed rapidly but the
cause of the diseases remains completely unknown. It has become
clear that dysregulation of the mucosal immune system is the basis
for the chronic evolution of the diseases in a genetically
susceptible population. Exciting new therapeutic approaches have
been attempted in the last couple of years and cytokine and
anti-cytokine treatments in particular seem very promising,
especially in intractable disease. The format of the Falk Symposium
106 on Advances in Inflammatory Bowel Diseases', held in Brussels,
Belgium, June 18-20, 1998, was somewhat innovative as each session
attempted to link the new insights into pathogenetic mechanisms
with new therapeutic approaches, resulting in optimal information
transfer. The classic therapeutic schemes were updated with a
special focus on step-wise build-up of therapy.
Most symposia on chronic inflammatory bowel disease during the last
few years have focused on new aspects of aetiology and
pathophysiology. However, based on such new aspects, changes in
diagnosis and treatment have been developed over the last few years
and some others are currently under investigation. This book, the
proceedings of Falk Symposium 97, `Clinical Challenges in
Inflammatory Bowel Diseases - Diagnosis, Prognosis and Treatment',
held in Lugano, Switzerland, 18-19 April 1997, summarizes these
changes and new developments, discusses their value and defines
further new approaches. The topics include primary diagnosis,
definition of different patient groups, special problems of these
patients in daily life and very new therapeutic principles. This
volume opens new possibilities of diagnosis and treatment of
inflammatory bowel disease to physicians and provides stimulation
for further development.
Portal hypertension is causally related to major complications of
chronic liver disease like upper GI tract bleeding, ascites
formation, portosystemic encephalopathy and bacterial infections.
In recent years, new approaches have increased our knowledge of the
underlying pathobiological events of these complications.
Accordingly, new promising treatment modalities have been developed
and introduced into clinical trials. This book, the proceedings of
the 79th Falk Symposium in Freiburg-im-Breisgau, Germany, 17--19
June 1994, presents the latest developments in the field, including
a section which describes the role of portal hypertension in the
pathogenesis of complications of chronic liver disease. Also
covered is the therapeutic management of portal hypertension and
its consequences as well as the latest endoscopic, interventional
and surgical treatment options. This book is essential reading for
those whose interests range from anatomy and pathobiology through
to practical recommendations for treatment of portal hypertension.
Although the first description of patients with what we now call
Crohn's disease or ulcerative colitis was published well before
1900, both disorders seem to be diseases of the twentieth century.
At the very start of the twenty-first century, it therefore seems
appropriate to look back and at the same time look forward and to
assess what knowledge has been gained during the last 100 years and
in what direction research and thereby clinical practice will go in
the future. This book, the proceedings of Falk Symposium No. 111
held in Freiburg, Germany, on June 19-20 1999, contains
contributions from experienced senior scientists on the state of
the art in pathophysiology, diagnosis and treatment, together with
unpublished and new findings from young researchers. Basic
scientists and clinicians are thereby involved in an exchange of
information which will lead to new directions for future research
and clinical management of inflammatory bowel diseases.
There is no single truth regarding the recognition and management
of IBD. In this regards the old dictum "there is no disease but the
patient" should be the golden rule. Nowadays, more complicated
Crohn's disease cases at relatively young ages are not unusual.
Various clinical and extraintestinal manifestations have been seen
rarely until now. The evolution of the therapeutic armamentarium is
now a double-edged sword since "more drugs" may mean "more
side-effects, less compliance and a more critical attitude of
health authorities towards the cost of treatment". Education of the
patient and the family, creation of empathy and a positive rapport
with the patient and a careful analysis of confounding/contributing
factors to the disease behaviour are essential elements of optimal
therapy of IBD patients. This book contains the proceedings of Falk
Symposium 159, entitled IBD 2007 -- Achievements in Research and
Clinical Practice, held in Istanbul, Turkey, on May 4--5, 2007,
where opinion leaders with worldwide reputations discuss IBD and
related issues in a less well-known part of the world with respect
to prevalence, disease behaviour and patient characteristics, as
well as the difficulties faced in differential diagnosis and
management.
This book, the proceedings of Falk Symposium 133 on Mechanisms of
Intestinal Inflammation: Implications for Therapeutic Intervention
in IBD', held in Berlin, Germany, on 10-11 June 2003, summarizes
present knowledge in the area of unspecific and specific immune
reactions in the gut, recording the gaps in our knowledge and, in
particular, presenting the possibilities of targeted intervention.
The link to inflammatory bowel diseases - Crohn's disease and
ulcerative colitis - is always in focus. Chapters by an
international panel of basic scientists, clinical researchers and
clinicians also record the problems which can originate through
today's possible modulation of the immune reaction, setting the
basis for review of clinical problems. This book is valuable
readings for all scientists and physicians, who, from different
perspectives, have an interest in research on IBD and in the
clinical management of these diseases.
This book is the proceedings of the Falk Symposium No. 122 on
"Inflammatory Bowel Disease - A Clinical Case Approach to
Pathophysiology, Diagnosis, and Treatment," held in Bologna, Italy,
on June 22-23, 2001, and deals with some major issues concerning
Genetics of IBD, Pediatrics in IBD, Early vs Late IBD, Bacteria and
Gut Inflammation, Refractory CD, Fistulizing CD, Refractory Distal
Colitis, and Complications of Ileal-Pouch Anastomosis. The main aim
of the meeting was to highlight the value of an integrated clinical
approach and the importance of clinical research in developing
innovative methods of treatment.
Zinc has an important role in human physiology due to its
involvement in numerous enzymatic reactions and its other functions
as part of hormones and structural proteins. As a consequence a
wide variety of symptoms may occur in different states of zinc
deficiency. Several diseases of the digestive tract can lead to
zinc deficiency and consequently to deficiency symptoms. This book,
the proceedings of an International Falk Workshop held in Freiburg,
Germany, on 27 October 1996, aims at a dialogue between basic
researchers and gastroenterologists in order to improve the
understanding of the role of zinc in disorders of the digestive
tract. Based on lectures on the role of zinc in cell biology, the
pathophysiology of zinc deficiency and consequently the
possibilities of zinc substitution in these disorders is discussed.
It is hoped that this book will initiate fruitful discussions and
collaborations leading to a better knowledge of the role of this
trace element in gastroenterology.
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