Clinics and research in hepatology and gastroenterology最新文献

{"title":"Evaluation of a nutritional education guide designed for patients living with cirrhosis: A randomized controlled mixed-methods study","authors":"Manila Sophasath ,&nbsp;Mélanie Tremblay ,&nbsp;Crystèle Hogue ,&nbsp;Alexandre Brisset ,&nbsp;Puneeta Tandon ,&nbsp;Geneviève Huard ,&nbsp;Christopher F. Rose ,&nbsp;Chantal Bémeur","doi":"10.1016/j.clinre.2025.102672","DOIUrl":"10.1016/j.clinre.2025.102672","url":null,"abstract":"<div><h3>Background</h3><div>Liver diseases are increasingly common in Canada, and patients with cirrhosis are at high risk for malnutrition due to difficulties in meeting energy and protein intake targets. This highlights the need for tailored nutritional interventions. This study evaluates the impact of the <em>Nutrition in Cirrhosis</em> guide on nutritional knowledge, quality of life (QoL), nutritional risk, and dietary intake, as well as patient satisfaction.</div></div><div><h3>Methods</h3><div>In this randomized controlled mixed-methods study, patients in the intervention group (Guide+) received and used the <em>Guide</em> for 6 months. Data was collected at baseline, 3 months and 6 months. Assessments included evaluation of nutritional knowledge (questionnaire based on the Guide), QoL (<em>Chronic Liver Disease Questionnaire</em>) and nutritional risk (<em>Liver Disease Undernutrition Screening Tool</em>). Satisfaction was evaluated with 3 focus groups including patients from the Guide+ group as well as a patient partner and thematic analysis was conducted.</div></div><div><h3>Results</h3><div>Thirty-nine patients were randomized into Guide+ (n=23) and Guide- (n=16) groups. The Guide+ group showed significantly greater improvement in nutritional knowledge (p=0.032) compared to Guide-. Knowledge scores increased from 74.3% at baseline to 84.0% after six months (p&lt;0.001), while no significant change was observed in Guide- (p=0.143). Nutritional risk decreased significantly in Guide+ patients (47.8% to 21.7%, p=0.021) but remained unchanged in controls. No significant QoL changes were observed. Focus groups identified three main themes: navigational challenges, outcomes and feelings associated with the <em>Guide</em>.</div></div><div><h3>Conclusion</h3><div>The <em>Nutrition in Cirrhosis</em> guide effectively improved nutritional knowledge and reduced nutritional risk in cirrhosis patients. Patient feedback highlighted areas for improvement, affirming the guide’s value in supporting nutritional education.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102672"},"PeriodicalIF":2.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859012","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":"Portal hypertension in alcohol-associated hepatitis: harmless and the reflection of systemic inflammation?","authors":"Karim Gebara ,&nbsp;Lionel Moulis ,&nbsp;Joana Pissarra ,&nbsp;Benjamin Rivière ,&nbsp;Georges-Philippe Pageaux ,&nbsp;José Ursic-Bedoya","doi":"10.1016/j.clinre.2025.102668","DOIUrl":"10.1016/j.clinre.2025.102668","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Portal hypertension is a prominent feature of alcohol-associated hepatitis. However, it is not established whether the severity of PH has a prognostic impact in AH. The aim of our study was to assess the impact of PH on 6-month transplantation-free survival (TFS).</div></div><div><h3>Methods</h3><div>A monocentric retrospective analysis was conducted on patients with symptomatic AH, proven histologically, admitted in our tertiary care hospital from January 2013 to December 2021.</div></div><div><h3>Results</h3><div>127 patients were included in the study, with a mean Discriminant Function and MELD score of 59.5 (±23.5) and 25.2 (±6.6), respectively. The only risk factor for severe PH at admission was the liver/spleen ratio. Patients were followed up for a median of 20 months. The median TFS was 16.8 months. Severe PH was not significantly associated with 6-month TFS, unlike the MELD score and nonresponse to corticosteroids. In addition, the leucocyte count was associated with persistent PH at 6 months.</div></div><div><h3>Conclusions</h3><div>In our study, severe PH had no impact on 6-month TFS. Further investigations on the prognostic value of PH and its natural history in AH are warranted.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102668"},"PeriodicalIF":2.4,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859025","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":"Opportunistic fast-track sub-submerged true underwater endoscopic mucosal resection (uEMR) for a gravity-sided rectal lesion during screening colonoscopy","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102671","DOIUrl":"10.1016/j.clinre.2025.102671","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102671"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854787","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":"Proton Pump Inhibitor Use and Risk of Hepatic Encephalopathy in Cirrhotic Patients: A Systematic Review and Meta-analysis","authors":"Hasan Jaber ,&nbsp;Sandra Chehayeb ,&nbsp;Janane Nasr ,&nbsp;Nader Al Souky ,&nbsp;Daly Al Hadeethi ,&nbsp;Hyrettin Okut ,&nbsp;Mathew Stotts ,&nbsp;William J. Salyers","doi":"10.1016/j.clinre.2025.102667","DOIUrl":"10.1016/j.clinre.2025.102667","url":null,"abstract":"<div><h3>Background</h3><div>Hepatic encephalopathy (HE) is a debilitating complication of liver cirrhosis, characterized by neuropsychiatric symptoms ranging from mild cognitive impairment to coma. Proton pump inhibitors (PPIs) are widely used in cirrhotic patients for managing gastrointestinal conditions. However, emerging evidence has suggested a potential link between PPI use and HE, possibly due to increased intestinal permeability and bacterial translocation.</div></div><div><h3>Objective</h3><div>To evaluate and synthesize current evidence on the association between PPI use and the risk of hepatic encephalopathy in patients with liver cirrhosis through a systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A total of 22 studies were included in this systematic review and meta-analysis, comprising both case-control and cohort designs. Hazard ratios (HRs) and odds ratios (ORs) were used to quantify the association between PPI use and the development of HE.</div></div><div><h3>Results</h3><div>The initial pooled analysis showed that PPI use was associated with an increased risk of HE, with a hazard ratio (HR) of 1.59 (95 % CI: 1.42–1.77) and an odds ratio (OR) of 2.07 (95 % CI: 1.57–2.72; I² = 96.4 %, p &lt; 0.0001).</div><div>In the OR group, a subgroup analysis by study type showed:</div><div><strong>Case-control studies</strong>: OR = 2.29 (95 % CI: 1.46–3.59, I² = 76.9 %, p &lt; 0.0017).</div><div><strong>Retrospective cohort studies</strong>: OR = 1.107 (95 % CI: 1.05–1.166, I² = 0 %, p = 0.97).</div><div>Nardelli et al. and Sun et al. were not pooled as they were prospective cohort studies.</div><div>In the HR group, all included studies were retrospective cohort studies, so no further subgroup analysis was performed.</div><div>After excluding high-risk studies/abstracts, the pooled HR was 1.49 (95 % CI: 1.266–1.743, I² = 37.9 %, p = 0.153).</div></div><div><h3>Conclusion</h3><div>This meta-analysis supports a potential association between PPI use and an increased risk of hepatic encephalopathy in cirrhotic patients. These findings underscore the importance of cautious and judicious use of PPIs in this vulnerable population, reserving them for clear clinical indications.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102667"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854788","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":"CT-quantified visceral fat and risk of gallbladder stones in Korean men: A cross-sectional study of 2939 cases","authors":"Seung Bum Lee ,&nbsp;Young-Jee Jeon ,&nbsp;Doo-Ho Lim","doi":"10.1016/j.clinre.2025.102670","DOIUrl":"10.1016/j.clinre.2025.102670","url":null,"abstract":"<div><h3>Background</h3><div>Gallbladder (GB) stones are a common gastrointestinal disorder influenced by metabolic and lifestyle factors. Visceral adiposity has been proposed as a key contributor to GB stone pathogenesis, but evidence using direct quantification of visceral fat in men is limited. This study aimed to investigate the association between visceral fat area, measured by abdominal pelvic computed tomography (CT), and the prevalence of GB stones in Korean men.</div></div><div><h3>Methods</h3><div>In this retrospective cross-sectional study, 2939 Korean men who underwent abdominal pelvic CT and ultrasonography during routine health examinations were included. Visceral and subcutaneous fat areas were quantified at the L3 vertebral level using CT images. Participants were categorized into quartiles based on fat area. Logistic regression models assessed the relationship between fat distribution and GB stone prevalence, adjusting for demographic, clinical, lifestyle, and biochemical factors.</div></div><div><h3>Results</h3><div>The mean age was 52.4 ± 9.6 years. The prevalence of GB stones increased significantly with higher visceral fat quartiles (<em>p</em>=0.010), while no significant trend was observed with subcutaneous fat. In the fully adjusted model, men in the highest visceral fat quartile had more than twice the odds of having GB stones compared to those in the lowest quartile (OR 2.108, 95 % CI 1.014–4.385, <em>p</em>=0.046), while subcutaneous fat showed no significant association.</div></div><div><h3>Conclusions</h3><div>Increased visceral fat, rather than subcutaneous fat, is independently associated with the presence of GB stones in Korean men. These findings highlight visceral adiposity as a significant risk factor for GB stone formation and suggest that incorporating visceral fat assessment could enhance risk stratification and early identification of individuals at risk.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102670"},"PeriodicalIF":2.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854786","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":"Removal notice to “Cola-caused inflated liver” [Clinics and Research in Hepatology and Gastroenterology, Volume 45, Issue 3, 101682]","authors":"Shaocheng Lyu,&nbsp;Fangfei Wang,&nbsp;Qiang He","doi":"10.1016/j.clinre.2025.102664","DOIUrl":"10.1016/j.clinre.2025.102664","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102664"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781259","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":"Reply to: “Nonalcoholic fatty liver disease and hepatocellular carcinoma”","authors":"Chang Hun Lee ,&nbsp;Min Gu Kang ,&nbsp;Shinyoung Oh ,&nbsp;Ji Hyun Park","doi":"10.1016/j.clinre.2025.102666","DOIUrl":"10.1016/j.clinre.2025.102666","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102666"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793632","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":"Metabolic factors drive early increase in hepatic steatosis despite improvement in non-invasive fibrosis markers after hepatitis C eradication with direct-acting antivirals: Letter to the editor","authors":"Leela Kumaran ,&nbsp;Sheifali Gupta","doi":"10.1016/j.clinre.2025.102662","DOIUrl":"10.1016/j.clinre.2025.102662","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102662"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752612","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":"Reconsidering the post-SVR landscape: Clinical implications of rising steatosis despite fibrosis regression","authors":"Nathkapach Kaewpitoon Rattanapitoon ,&nbsp;Nav La ,&nbsp;Schawanya Kaewpitoon Rattanapitoon","doi":"10.1016/j.clinre.2025.102661","DOIUrl":"10.1016/j.clinre.2025.102661","url":null,"abstract":"<div><div>The recent work by Shengir et al. offers compelling insight into the evolving metabolic landscape following hepatitis C virus (HCV) eradication via direct-acting antivirals (DAAs). While liver stiffness and fibrosis indices significantly improved post-SVR, hepatic steatosis (HS) paradoxically increased in prevalence, highlighting a shift from virus-driven injury to metabolic dysfunction-associated steatotic liver disease (MASLD). In this correspondence, we expand upon these findings by discussing the clinical and pathophysiological implications of post-SVR steatosis, underscoring the need for ongoing metabolic surveillance even in patients with virologic cure. We also emphasize the limitations of traditional risk stratification based on BMI alone and call for refined, longitudinal approaches to detect and manage metabolic liver disease in the post-SVR population.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102661"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752613","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":"Multi-omics profiling and molecular pathways in esophageal adenocarcinoma","authors":"Qi Gao ,&nbsp;Jing Xun ,&nbsp;Bin Liu ,&nbsp;Xiaolin Jiang ,&nbsp;Yu Wang ,&nbsp;Qi Zhang ,&nbsp;Yu Wu","doi":"10.1016/j.clinre.2025.102653","DOIUrl":"10.1016/j.clinre.2025.102653","url":null,"abstract":"<div><div>Esophageal adenocarcinoma (EAC) is an aggressive malignancy with a rising incidence and poor prognosis. This review integrates current insights into the molecular features of EAC, focusing on the application of multi-omics approaches to unravel its genetic, transcriptomic, metabolic, and microenvironmental alterations. By identifying key biomarkers and therapeutic targets, we highlight the transformative potential of multi-omics in advancing precision medicine for EAC.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 8","pages":"Article 102653"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749075","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}