Clinics and research in hepatology and gastroenterology最新文献

{"title":"Safety and efficacy of index admission cholecystectomy in severity-stratified acute cholangitis hospitalizations","authors":"Ali Jaan ,&nbsp;Mostafa Suhail Najim ,&nbsp;Adeena Maryyum ,&nbsp;Qurat Ul Ain Muhammad ,&nbsp;Effa Zahid ,&nbsp;Umer Farooq ,&nbsp;Ashish Dhawan ,&nbsp;Haseeba Javed ,&nbsp;Byron Cryer ,&nbsp;Sushil Ahlawat","doi":"10.1016/j.clinre.2025.102676","DOIUrl":"10.1016/j.clinre.2025.102676","url":null,"abstract":"<div><h3>Introduction</h3><div>Cholecystectomy (CCY) is generally advocated for patients presenting with acute cholangitis (AC) to ensure definitive management and prevent recurrence. The optimal timing for cholecystectomy (CCY), however, remains to be determined. This study aims to comprehend the clinical outcomes and financial implications of performing a CCY during index admission.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using data from the Nationwide Readmission Database (2016–2020). Adult patients admitted with a diagnosis of AC were categorized based on whether CCY was performed during index admission and were further stratified by severity per the Tokyo Guidelines. Mortality, resource utilization, and readmission rates were analyzed using a multivariate Cox regression model. STATA 14.2 was utilized for statistical analysis.</div></div><div><h3>Results</h3><div>Of 29,241 adult patients with AC, 4319 (14.77 %) underwent CCY during the index admission. Patients with index admission CCY had lower comorbidity index and AC severity compared to those without index admission CCY (<em>P</em> &lt; 0.01). Significantly lower in-hospital mortality (adjusted hazard ratio (aHR) 0.40, <em>P</em> &lt; 0.01), 30-day and 90-day readmission rates (aHR 0.49 and 0.48 respectively, <em>P</em> &lt; 0.01) were observed for the index CCY group. Reduced mortality and improved readmission rates were persistent on subgroup analysis for severe and non-severe cholangitis patients.</div></div><div><h3>Conclusion</h3><div>Our findings advocate the effectiveness of index admission CCY in lowering mortality and readmission rates, irrespective of AC severity. These findings highlight the need for future prospective studies and updated guidelines on surgical intervention in AC management.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102676"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term risk of inflammatory bowel disease in autoimmune hepatitis: Over a 20-year population-based study","authors":"Mifleh Tatour ,&nbsp;Fadi Abu Baker ,&nbsp;Tarek Saadi ,&nbsp;Rawi Hazzan","doi":"10.1016/j.clinre.2025.102682","DOIUrl":"10.1016/j.clinre.2025.102682","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune hepatitis (AIH) is a chronic immune-mediated liver disease with a recognized, but incompletely defined, association with inflammatory bowel disease (IBD). The long-term risk of developing IBD in AIH patients and its influence on hepatic outcomes remain unclear.</div></div><div><h3>Aim</h3><div>To determine the incidence and risk factors for IBD in a large AIH cohort over a 20-year follow-up and to assess its impact on liver-related complications.</div></div><div><h3>Methods</h3><div>We performed a retrospective, population-based study using data from Clalit Health Services in Israel, including 1284 adult patients diagnosed with AIH between 2000 and 2024. Patients with pre-existing cirrhosis, other chronic liver diseases, or IBD prior to AIH diagnosis were excluded. Demographic, clinical, and outcome data were analyzed.</div></div><div><h3>Results</h3><div>Over a median follow-up of 4.8 years, 9.81 % of AIH patients developed IBD, most commonly Crohn’s disease. The cumulative incidence of IBD increased with longer follow-up. Smoking was identified as an independent risk factor for IBD development. Patients with both AIH and IBD had a higher prevalence of cirrhosis compared with those with AIH alone, but rates of other major hepatic complications were similar between groups.</div></div><div><h3>Conclusion</h3><div>In this nationwide cohort, the incidence of IBD among AIH patients increased progressively over time, with smoking emerging as a modifiable risk factor. While IBD was associated with a greater prevalence of cirrhosis, it did not increase the risk of other liver-related complications.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102682"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A series of pediatric patients with inflammatory bowel disease switching from intravenous to subcutaneous infliximab maintenance therapy","authors":"Anne Sophie Duquerois ,&nbsp;Christine Martinez-Vinson ,&nbsp;Thomas Loppinet ,&nbsp;Lioara Restier ,&nbsp;Pierre Poinsot ,&nbsp;Aurélie Portefaix ,&nbsp;Sophie Heissat ,&nbsp;Noel Peretti ,&nbsp;Nicolas Caron ,&nbsp;Rémi Duclaux-Loras","doi":"10.1016/j.clinre.2025.102680","DOIUrl":"10.1016/j.clinre.2025.102680","url":null,"abstract":"<div><h3>Objective</h3><div>Infliximab is approved for pediatric Crohn's disease (CD) and ulcerative colitis (UC), but is limited in children by its intravenous administration. We evaluated the effectiveness and safety of switching from intravenous to subcutaneous infliximab in pediatric patients with CD/UC.</div></div><div><h3>Methods</h3><div>Multicenter retrospective cohort study, from January to December 2022 in two pediatric centers, that included CD/UC patients in clinical remission and weighing ≥50 kg, treated with maintenance dose IV IFX. Primary endpoint: maintenance of clinical remission at six-months post-switch; PCDAI&lt;10 for CD, PUCAI&lt;10 for UC. Secondary endpoints included: IFX trough levels, anti-infliximab antibodies (AIAs), adverse events, and treatment persistence.</div></div><div><h3>Results</h3><div>Twenty-one patients were included: 11 (52.3 %) female, median 17 years of age (range: 13–18 years), 18 (85.7 %) CD and 3 (14.3 %) UC. The median (range) age at diagnosis was 12 (5–15) years; at inclusion (M0; switch) it was 16 (10–18) years. All received optimized IFX regimens (10mg/kg every 8 or 4 weeks). All were in clinical remission at M0 and maintained remission throughout the 6-month follow-up. None discontinued treatment. Median (range) serum IFX trough levels was 11.3μg/mL (4.7–39μg/mL; <em>n</em> = 13) at M0, 17.8μg/mL (8.5–20μg/mL; <em>n</em> = 10) at M3, and 20μg/mL (17.1–20μg/mL; <em>n</em> = 6) at M6. No patient developed AIAs. There was no serious adverse event; one patient (4.7 %) experienced a mild injection site reaction.</div></div><div><h3>Conclusion</h3><div>Switching from IV to SC IFX appears effective and safe in pediatric IBD patients. Pharmacokinetic studies are required for children &lt;50 kg in order to determine the dosage of SC IFX that allows therapeutic trough values to be achieved.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102680"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis D, a new declared enemy: a little-known carcinogen that must be urgently combated in sub-Saharan Africa","authors":"Stanis DONNANG ,&nbsp;Dujardin MAKEDA ,&nbsp;Joshua EKOUO ,&nbsp;Christian TAGUE ,&nbsp;Hermann YOKOLO","doi":"10.1016/j.clinre.2025.102679","DOIUrl":"10.1016/j.clinre.2025.102679","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102679"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality reduction or selection bias? Interpreting outcomes of index admission cholecystectomy in acute cholangitis","authors":"Parth Aphale,&nbsp;Himanshu Shekhar,&nbsp;Shashank Dokania","doi":"10.1016/j.clinre.2025.102683","DOIUrl":"10.1016/j.clinre.2025.102683","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102683"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of a French screening campaign comparing clinical and molecular characteristics of interval colorectal cancers to cancers detected using a guaiac test","authors":"Carole Vitellius ,&nbsp;Benjamin Morvant ,&nbsp;Estelle Pedrono ,&nbsp;Diane Lambert ,&nbsp;Mylène Monteil ,&nbsp;Eric Lavoine ,&nbsp;Anne-Sophie Banaszuk ,&nbsp;Philippe Guardiola ,&nbsp;François-Xavier Caroli-Bosc","doi":"10.1016/j.clinre.2025.102678","DOIUrl":"10.1016/j.clinre.2025.102678","url":null,"abstract":"<div><div>Few studies have analyzed the biological characteristics of interval colorectal cancers (CRC) during a screening campaign. We included 98 patients of whom 46 had a screened cancer (SCG) and 52 an interval cancer (ICG). Microsatellite instability and gene mutation profiling were performed in 86 and 55 patients, respectively. ICG were diagnosed with more advanced diseases. A time interval between last negative test and CRC diagnosis (TIg2D) ≥ 18 months, in the ICG, was associated with an increased risk of metastasis at diagnosis. Old age, male gender, rectal cancer and TIg2D ≥ 18 months were associated with a worse outcome in ICG. Interval cancers remained associated with a worse survival in an adjusted Cox model. There was no significant difference in terms of mutation frequency between SCG and ICG. However, <em>APC / CTNNB1</em> mutations were less frequent in rectum cancers of ICG. Furthermore, <em>KRAS</em> activating mutations were less frequent in the ICG when age at diagnosis was below 65 years or if patients had colon cancer. When compared to the SCG, the survival of ICG was significantly worse in patients with wild-type <em>KRAS</em>. These results suggest that men and elderly subjects could benefit from annual screening. Patients with rectum cancer and wild-type <em>APC</em>/<em>CTNNB1</em>/<em>KRAS</em> should be considered as high-risk subjects.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102678"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GGT-normal cholestasis associated with LSR deficiency: A potential new subtype of PFIC","authors":"Ozlem Sumer Cosar ,&nbsp;Hakan Ozturk ,&nbsp;Gulsum Kayhan ,&nbsp;Ayse Can ,&nbsp;Sınan Sarı ,&nbsp;Guldal Esendağlı ,&nbsp;Buket Dalgıc","doi":"10.1016/j.clinre.2025.102674","DOIUrl":"10.1016/j.clinre.2025.102674","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary cholestatic liver diseases are a group of disorders caused by different gene mutations encoding proteins involved in bile production, transport, or secretion. New genetic disorders have been identified in cholestatic patients through an increased understanding of these proteins, evolving genetic technology and more widespread genetic testing. Recently, mutations in the Lipolysis-Stimulated Lipoprotein Receptor (<em>LSR</em>) gene have been identified as a novel cause of infantile intrahepatic cholestasis. To date, only two cases have been reported in the literature. Here, we present two children with GGT normal cholestasis with <em>LSR</em>-gene variants.</div></div><div><h3>Methods</h3><div>Two pediatric patients with GGT-normal cholestasis underwent genetic analysis, including whole-exome sequencing. Clinical, laboratory, and histopathological findings were reviewed, and genetic variants were evaluated.</div></div><div><h3>Results</h3><div>Both patients exhibited progressive cholestasis with normal GGT levels, and genetic analysis identified homozygous missense variants in the <em>LSR</em> gene. These cases' clinical presentation and disease course shared similarities with previously reported LSR-related cholestasis, suggesting a common pathogenic mechanism.</div></div><div><h3>Conclusions</h3><div>These findings further support the <em>LSR</em> gene as a novel cause of GGT normal cholestasis. Identifying additional cases provides crucial insights into the genotype-phenotype correlation, aiding in the early diagnosis and management of affected patients. Expanding the number of reported cases will contribute to a better understanding of disease progression and potential therapeutic strategies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102674"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving fecal sample collection in patients with inflammatory bowel disease: A comparative evaluation of two calprotectin devices.","authors":"Giulia Pasi, Amale Antari, Damien Masson, Thomas Dejoie, Marie-Anne Vibet, Michael Collins, Hélène Caillon, Arnaud Bourreille, Catherine Le Berre","doi":"10.1016/j.clinre.2025.102665","DOIUrl":"10.1016/j.clinre.2025.102665","url":null,"abstract":"<p><strong>Background: </strong>Fecal calprotectin (FC) is a non-invasive biomarker that can be used to guide treatment decisions in inflammatory bowel diseases (IBD). Low compliance may hinder routine testing, with stool collection being the primary obstacle.</p><p><strong>Aims: </strong>The objective was to compare an alternative collection device (sampling bottle) to a conventional container for stool sampling in terms of acceptability and compliance with FC testing in patients with IBD.</p><p><strong>Methods: </strong>In this prospective study, patients were randomly assigned 1:1 to either the standard laboratory method (Bühlmann fCAL® turbo) or the ProciseFCP™ assay. Acceptability was assessed using qualitative and quantitative scales. Factors associated with FC acceptability, and compliance with FC testing, were analyzed. Only the stool sampling procedure was evaluated, not the satisfaction with the 'point-of-care' assay.</p><p><strong>Results: </strong>In total, 156 patients were included. The ProciseFCP™ device was associated with higher acceptability than the standard container on the ordinal scale (primary outcome) (OR 2.69, p < 0.001). Using the visual analog scale (secondary outcome), a positive difference of 30.0 % (95 % CI: 19.7 to 44.7) was found in favor of the ProciseFCP™ arm, but this was not statistically significant (CI including the predefined threshold of a 30-point difference). Compliance was similar and high in both groups (80 %).</p><p><strong>Conclusion: </strong>This study demonstrates that a sampling bottle offers a patient-friendly alternative to the conventional stool container, significantly enhancing patient's acceptability with stool collection. These findings support the integration of patient-centric innovations in diagnostic testing to improve the monitoring and management of IBD.</p>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102665"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflation as a gut health crisis: The SAFEGUARD framework","authors":"Rushabh H. Doshi ,&nbsp;Bhav Jain ,&nbsp;Fatima Cody Stanford","doi":"10.1016/j.clinre.2025.102673","DOIUrl":"10.1016/j.clinre.2025.102673","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102673"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac metastasis of colorectal cancer: a case report and review of literature","authors":"Ambre Besson,&nbsp;Claire Gallois,&nbsp;Céline Lepere,&nbsp;Jeanne Netter,&nbsp;Julien Taieb,&nbsp;Widad Lahlou","doi":"10.1016/j.clinre.2025.102669","DOIUrl":"10.1016/j.clinre.2025.102669","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102669"},"PeriodicalIF":2.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}