Digestive and Liver Disease最新文献

{"title":"From erosive to non-erosive reflux disease: broadening the scope of P-CAB therapy.","authors":"Carmelo Scarpignato, Luigi Gatta","doi":"10.1016/j.dld.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.013","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of high-risk hepatoblastoma in the CHIC risk stratification system based on enhanced CT radiomics features.","authors":"Yanlin Yang, Jiajun Si, Ke Zhang, Jun Li, Yushan Deng, Fang Wang, Huan Liu, Ling He, Xin Chen","doi":"10.1016/j.dld.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.017","url":null,"abstract":"<p><strong>Background: </strong>Survival of patients with high-risk hepatoblastoma remains low, and early identification of high-risk hepatoblastoma is critical.</p><p><strong>Objective: </strong>To investigate the clinical value of contrast-enhanced computed tomography (CECT) radiomics in predicting high-risk hepatoblastoma.</p><p><strong>Methods: </strong>Clinical and CECT imaging data were retrospectively collected from 162 children who were treated at our hospital and pathologically diagnosed with hepatoblastoma. Patients were categorized into high-risk and non-high-risk groups according to the Children's Hepatic Tumors International Collaboration - Hepatoblastoma Study (CHIC-HS). Subsequently, these cases were randomized into training and test groups in a ratio of 7:3. The region of interest (ROI) was first outlined in the pre-treatment venous images, and subsequently the best features were extracted and filtered, and the radiomics model was built by three machine learning methods: namely, Bagging Decision Tree (BDT), Logistic Regression (LR), and Stochastic Gradient Descent (SGD). The AUC, 95 % CI, and accuracy of the model were calculated, and the model performance was evaluated by the DeLong test.</p><p><strong>Results: </strong>The AUCs of the Bagging decision tree model were 0.966 (95 % CI: 0.938-0.994) and 0.875 (95 % CI: 0.77-0.98) for the training and test sets, respectively, with accuracies of 0.841 and 0.816,respectively. The logistic regression model has AUCs of 0.901 (95 % CI: 0.839-0.963) and 0.845 (95 % CI: 0.721-0.968) for the training and test sets, with accuracies of 0.788 and 0.735, respectively. The stochastic gradient descent model has AUCs of 0.788 (95 % CI: 0.712 -0.863) and 0.742 (95 % CI: 0.627-0.857) with accuracies of 0.735 and 0.653, respectively.</p><p><strong>Conclusions: </strong>CECT-based imaging histology identifies high-risk hepatoblastomas and may provide additional imaging biomarkers for identifying high-risk hepatoblastomas.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of adjuvant therapy on long-term survival in patients with duodenal adenocarcinoma: Insights from a population-based propensity-matched study.","authors":"Di Zhang, Yuan Zheng, Jiaoyang Lu","doi":"10.1016/j.dld.2025.06.024","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.024","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of adjuvant treatment in resected duodenal adenocarcinoma has not been well established. This study aimed to evaluate the impact of postoperative chemotherapy (POCT) and postoperative chemoradiotherapy (POCRT) on survival in this rare malignancy.</p><p><strong>Methods: </strong>Patients diagnosed with duodenal adenocarcinoma from SEER database between 2004 and 2019 were identified. Overall survival (OS) and cancer-specific survival (CSS) were analyzed before and after propensity score matching (PSM). Subgroup analyses were conducted to identify which patient groups benefited from adjuvant therapy.</p><p><strong>Results: </strong>Among the 1320 eligible patients, 33.8 % received surgery plus POCT, and 10.8 % received surgery plus POCRT. Compared to surgery alone, POCT significantly improved OS both before and after PSM (P < 0.001). While no significant CSS benefit was observed in the unmatched population, PSM analysis showed improved CSS with POCT (P < 0.001). In contrast, POCRT did not improve OS or CSS, regardless of PSM. Subgroup analyses revealed no survival benefit from POCT in patients younger than 68, those with N0 stage, stage I-II disease, or Black race. POCRT did not significantly improve outcomes in any subgroup.</p><p><strong>Conclusions: </strong>POCT demonstrates a survival benefit in locally advanced duodenal adenocarcinoma, whereas POCRT does not improve outcomes. Patients younger than 68, with N0 stage, stage I-II disease, or of Black race may not benefit from POCT.</p><p><strong>Impact: </strong>These findings guide clinical decision-making by identifying patient subgroups that benefit from adjuvant chemotherapy while suggesting limited utility for chemoradiotherapy in this setting.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Vascular complications in hospitalized patients with inflammatory bowel disease and acute gastroenteritis and colitis\".","authors":"Manal Sharif, Hassan Iqbal, Zulfiqar Ahmad, Abdur Rehman, Muhammad Sudais Hassan","doi":"10.1016/j.dld.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.010","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population stratification using MASLD polygenic risk score improves severe liver disease prediction by clinical fibrosis scores.","authors":"Zhenqiu Liu, Huangbo Yuan, Chen Suo, Li Jin, Tiejun Zhang, Xingdong Chen","doi":"10.1016/j.dld.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.016","url":null,"abstract":"<p><strong>Background and aim: </strong>Existing polygenic risk scores (PRS) for severe liver disease (SLD) have limited predictive ability, highlighting a possible reorientation for PRS application in clinical practice.</p><p><strong>Methods: </strong>Using non-overlapping subsets of the UK Biobank cohort, we first conducted a genome-wide association study of magnetic resonance imaging-derived hepatic fat content (HFC; n = 12,838), and then constructed a polygenic risk score to capture genetically predicted HFC (gHFC), which was applied in an independent sample (n = 426,529) to stratify individuals and evaluate the performance of clinical fibrosis scores.</p><p><strong>Results: </strong>Among 426,529 participants, 4417 developed SLD during follow-up. gHFC alone showed limited predictive power for SLD, and adding it to fibrosis scores did not improve AUROC. However, population stratification by gHFC substantially improved the performance of Fibrosis-4 (FIB-4), Forns, and Aspartate aminotransferase-to-Platelet Ratio Index (APRI), particularly for hepatocellular carcinoma (HCC). In the highest gHFC quintile, the areas under the receiver operating characteristic curve for HCC were 0.819 (FIB-4), 0.877 (Forns), and 0.851 (APRI), significantly higher than in the lowest quintile. Similar trends were observed using two alternative HFC PRSs.</p><p><strong>Conclusion: </strong>Stratifying the population by PRS before using clinical fibrosis scores to predict SLD is a more effective approach than considering PRS as an alternative or an addition to clinical risk models.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine screening for carbapenemase-producing organisms in ERCP: A step toward safer endoscopy practice.","authors":"Huan Luo, Lei Pu","doi":"10.1016/j.dld.2025.06.022","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.022","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply: \"Comment on gluten challenge study in adults on a gluten-free diet with unconfirmed coeliac disease\".","authors":"Stiliano Maimaris, Annalisa Schiepatti, Federico Biagi","doi":"10.1016/j.dld.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.023","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on ``Dietary lipophilic index and odds of metabolic dysfunction-associated steatotic liver disease (MASLD): A population-based survey''.","authors":"Laiba Saher, Sahar Haseeb","doi":"10.1016/j.dld.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.009","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Italian guidelines for the diagnosis and treatment of functional dyspepsia - joint consensus from the Italian societies of gastroenterology and endoscopy (SIGE), Neurogastroenterology and motility (SINGEM), hospital gastroenterologists and endoscopists (AIGO), digestive endoscopy (SIED) and general medicine (SIMG).","authors":"Giovanni Sarnelli, Marcella Pesce, Giovanni Barbara, Nicola de Bortoli, Antonio Di Sario, Giuseppe Esposito, Marzio Frazzoni, Giuseppe Galloro, Luigi Gatta, Matteo Ghisa, Claudio Londoni, Elisa Marabotto, Alberto Meggio, Antonio Pisani, Mentore Ribolsi, Paolo Usai Satta, Vincenzo Savarino, Carmelo Scarpignato, Vincenzo Stanghellini, Cesare Tosetti, Pierfrancesco Visaggi, Fabiana Zingone, Brigida Barberio, Edoardo Vincenzo Savarino","doi":"10.1016/j.dld.2025.06.012","DOIUrl":"10.1016/j.dld.2025.06.012","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Functional dyspepsia (FD) is one of the most prevalent disorders of the upper gastrointestinal tract. Despite its broad prevalence, FD diagnosis and treatment are still not well standardized. The aim of this project was to outline an Italian Guideline to define a standardized approach in terms of diagnostic and therapeutic work-up to support both general practitioners and specialists in Gastroenterology. To address this issue, experts from 5 Italian Societies conducted a Delphi consensus process, which included a review of the current literature and voting process on 24 key statements. Recommendations and quality of evidence were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Consensus for each statement was defined as ≥ 80 % agreement. DIAGNOSTIC APPROACH: The panel reached consensus on defining FD and its main symptoms and dividing this entity into two different subgroups: the epigastric pain syndrome (EPS) and the post-prandial distress syndrome (PDS). Consensus was reached on defining FD as a diagnosis of exclusion and on the need of performing an esophagogastroduodenoscopy with biopsies to exclude organic causes in patients 45 or older, in presence of alarm symptoms and/or in case of refractoriness to treatment. It was agreed that all patients should be screened for H. pylori infection (by invasive or non-invasive means) and that all HP-positive patients should receive eradication therapy. Routine blood tests were recommended to exclude underlying systemic diseases that could present with dyspeptic symptoms. On the other hand, the panel recommended against the routine use of additional testing, including abdominal ultrasound, celiac disease screening and motility studies in FD patients. TREATMENT APPROACH: Consensus was not reached regarding the dietary regimen to adopt in FD patients. Healthy general lifestyle advice was deemed as reasonable to pursue in FD patients, while the use of exclusion diets was discouraged by the panel. The consensus supports a short course of PPIs at standard dose as a first line treatment in FD patients, regardless of the prevalent symptom pattern, while higher PPI doses should not be pursued as an effective strategy in improving patient's response. Consensus was not reached regarding the routine use of H2RA, antacids and alginate-containing products and/or mucosal protectants in the management of FD. The panel recommended against the use of prokinetics as first line treatment in FD patients and advised on preferentially using a short course of prokinetics in PDS-subtype patients. The panel recommends the use of tricyclic antidepressants to treat EPS and supports the use of mirtazapine for FD patients, particularly for those patients with weight loss, while no sufficient evidence was available to recommend SSRIs. The panel recommends the use of cognitive and behavioral therapy for dyspepsia patients who do not respond to medical therapies. Finally, ","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of exercise therapies on functional dyspepsia: A systematic review and meta-analysis.","authors":"Zhiyan Huang, Yue Zhuang, Tianchen Lin, Shan Liu, Jiannong Wu","doi":"10.1016/j.dld.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.dld.2025.06.004","url":null,"abstract":"<p><p>Drug therapy is the primary treatment for functional dyspepsia (FD), but exercise therapy may offer a promising, safe, and effective adjunct. This meta-analysis evaluated the effectiveness of exercise therapy compared to conventional treatments for FD. We reviewed randomized controlled trials (RCTs) published up to October 13, 2024, from five databases. Pooled estimates were calculated using random-effects models, with outcomes expressed as risk ratio (RR), mean difference (MD), or standardized mean difference (SMD), and 95 % confidence intervals (CI). Subgroup analyses were performed based on the control treatment methods. Fifteen RCTs involving 1359 FD patients were included. All studies reported symptom improvement, with nine assessing the effective rate, and four evaluating overall symptom scores. Key symptoms, such as epigastric fullness and pain, showed improvements, and exercise therapy also enhanced quality of life (6 studies), sleep quality (2 studies), and reduced depression (2 studies). Additionally, exercise therapy was associated with changes in the endocrine levels of MTL, GAS, and VIP, although not all hormones were equally affected. No serious adverse events were reported. In conclusion, exercise therapy significantly benefits FD patients across various aspects, providing valuable insights for future treatment strategies.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}