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Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians

Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographi...

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Autores principales: Portincasa, Piero, Di Ciaula, Agostino, Grattagliano, Ignazio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Family Medicine 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961852/
https://www.ncbi.nlm.nih.gov/pubmed/27468338
http://dx.doi.org/10.4082/kjfm.2016.37.4.205
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author Portincasa, Piero
Di Ciaula, Agostino
Grattagliano, Ignazio
author_facet Portincasa, Piero
Di Ciaula, Agostino
Grattagliano, Ignazio
author_sort Portincasa, Piero
collection PubMed
description Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case–controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting.
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spelling pubmed-49618522016-07-27 Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians Portincasa, Piero Di Ciaula, Agostino Grattagliano, Ignazio Korean J Fam Med Review Article Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case–controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting. The Korean Academy of Family Medicine 2016-07 2016-07-21 /pmc/articles/PMC4961852/ /pubmed/27468338 http://dx.doi.org/10.4082/kjfm.2016.37.4.205 Text en Copyright © 2016 The Korean Academy of Family Medicine http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Portincasa, Piero
Di Ciaula, Agostino
Grattagliano, Ignazio
Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
title Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
title_full Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
title_fullStr Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
title_full_unstemmed Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
title_short Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians
title_sort preventing a mass disease: the case of gallstones disease: role and competence for family physicians
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961852/
https://www.ncbi.nlm.nih.gov/pubmed/27468338
http://dx.doi.org/10.4082/kjfm.2016.37.4.205
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