Digestive and Liver Disease最新文献

{"title":"Body weight-range based initial dosing of ustekinumab in Crohn's disease: Is it an ideal approach?","authors":"Zhaopeng Huang, Lang Lin, Qing Li, Yanhui Wu, Taofeng Jiang, Zhimei Sun, Haiyan Zhang, Lingyu Fu, Xiaoling Wang, Qiaoqiao Yang, Hongsheng Yang, Zicheng Huang, Miao Li, Qin Guo, Xiang Gao, Kang Chao, Jian Tang","doi":"10.1016/j.dld.2025.01.203","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.203","url":null,"abstract":"<p><strong>Background & aims: </strong>The initial intravenous dose of ustekinumab (UST) for treating Crohn's disease (CD) is recommended based on body weight ranges for clinical convenience. However, patients whose body weight nears the upper threshold may receive a relatively lower dose (<6 mg/kg) based on current dosage calculations. We aimed to investigate whether the body weight-range based dosing calculation method for UST may lead to suboptimal therapeutic doses and then impact effectiveness, particularly in patients with borderline weight.</p><p><strong>Methods: </strong>A multi-center, observational, real-world cohort study was conducted in four centers. Patients with CD who received UST based on body weight-range dosing calculation were retrospectively enrolled. Participants were classified into two groups according to the initial induction dosage: the relatively higher dose (RHD) induction group (≥6 mg/kg) and the relatively lower dose (RLD) induction group (<6 mg/kg). Steroid-free remission, clinical remission, specific objective response and remission at week 24 were compared in the two groups using propensity score weighting. UST drug concentration was measured at week 24±4.</p><p><strong>Results: </strong>A total of 438 patients were included, with 176 patients in the RHD group and 262 patients in the RLD group. The RHD group demonstrated superior outcomes compared to the RLD group in achieving steroid-free remission (66.2 % vs. 54.9 %, P = 0.020, OR = 1.605, 95 % CI 1.082-2.395), clinical remission (66.7 % vs. 56.4 %, P = 0.032, OR = 1.546, 95 % CI 1.041-2.311) at week 24. In objective evaluation, the RHD group showed higher rates in ultrasound response (64.9 % vs. 52.1 %, P = 0.041, OR = 1.700, 95 % CI 1.027-2.844) and radiologic remission (25.1 % vs. 13.4 %, P = 0.022, OR = 2.163, 95 % CI 1.117-4.205). The drug concentration was significantly higher in the RHD group compared to the RLD group at week 24 [2.06 (1.36-3.17) µg/ml vs. 1.12 (0.25-1.52) µg/ml, P < 0.001]. Additionally, the RHD group required fewer treatment optimizations than the RLD group, but with no statistical difference (20.6 % vs. 24.9 %, P = 0.291, OR = 0.780, 95 % CI 0.488-1.231). The rate of adverse events was similar between the two groups (4.0 % vs 3.4 %, P = 0.767).</p><p><strong>Conclusions: </strong>This study suggested that the current dose calculation method may result in inadequate induction doses of UST for CD patients whose body weight is close to the upper threshold, potentially impacting the effectiveness of induction.</p><p><strong>Lay summary: </strong>A multi-center study suggests that the current body weight-range based dosing of ustekinumab for Crohn's disease may lead to insufficient induction doses for patients near the upper weight threshold, negatively impacting treatment effectiveness.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406392","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":"Corrigendum to \"The CCL21/CCR7 pathway plays a key role in human colon cancer metastasis through regulation of matrix metalloproteinase-9\" [Digestive and Liver Disease 43 (2011) 40-47].","authors":"Jiang Li, Renhu Sun, Kaixiong Tao, Guobin Wang","doi":"10.1016/j.dld.2025.01.205","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.205","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398605","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":"Vascular complications in hospitalized patients with inflammatory bowel disease and acute gastroenteritis and colitis: A propensity score-matched study.","authors":"Alfredo Papa, Lucrezia Laterza, Valerio Papa, Loris Riccardo Lopetuso, Stefania Colantuono, Gaetano Coppola, Benedetta Simeoni, Franco Scaldaferri, Francesco Franceschi, Antonio Gasbarrini, Marcello Covino","doi":"10.1016/j.dld.2025.01.195","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.195","url":null,"abstract":"<p><strong>Objectives: </strong>Atherosclerotic cardiovascular disease (ASCVD) and venous thromboembolism (VTE) are severe complications of inflammatory bowel disease (IBD). Risk factors for ASCVD and VTE in IBD are not entirely elucidated. This study investigated the incidence and risk factors for ASCVD and VTE in IBD compared to acute infective gastroenteritis and colitis (AGC).</p><p><strong>Methods: </strong>We reviewed the clinical records of inpatients with IBD and AGC over 6 years. Each group's propensity score-matched (PS) subpopulation consisted of 831 patients, ensuring a balanced comparison. Additionally, the effect of IBD on ASCVD and VTE was assessed.</p><p><strong>Results: </strong>The PS cohorts indicated a significantly higher number of ASCVD events in IBD than controls (10.1 % vs. 5.5 %, p = 0.001) and an increased prevalence of ischemic heart disease (IHD) (7.9 % vs. 3.6 %, p < 0.001). Conversely, the study groups demonstrated similar VTE incidence. IBD diagnosis, male sex, hypertension, diabetes, and the Charlson Index were independently associated with ASCVD. Age was significantly associated with VTE.</p><p><strong>Conclusions: </strong>Inpatients with IBD demonstrated an increased risk of ASCVD and IHD. IBD was an independent risk factor for ASCVD, and chronic inflammation was a significant enhancer factor for ASCVD. Aggressive control of inflammation is an essential target to reduce ASCVD risk.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398610","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":"Long-term validation of intra-cystic biomarkers for pancreatic cysts.","authors":"Ana López-Peña, Marta Herreros-Villanueva, Abian Olga, Sonia Hermoso-Durán, Goel Ajay, Cristina Sarasqueta, Luis Bujanda","doi":"10.1016/j.dld.2025.01.200","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.200","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic Cyst Lesions (PCLs) are frequently diagnosed in radiologic imaging tests and can be classified as benign, premalignant and malignant. Their correct stratification is essential and has significant implications for the patient. The objective of the study was to determine the clinical and analytical characteristics that can help in their differential diagnosis.</p><p><strong>Methods: </strong>This observational retrospective study included patients with PCLs diagnosed by endoscopic ultrasound from 2011 to 2023. Data collected included age, sex, personal history, treatments, toxic habits, family history of cancer, body mass index, and radiological and serological findings. The following intra-cyst levels were gathered: glucose, amylase, lipase, CEA and CA19.9.</p><p><strong>Results: </strong>271 patients with PCLs were included, 93 (35%) of them were benign, 55 (20%) were premalignant, and 123 (45%) malignant. Serous cystadenomas were the most common benign lesion in 71 (76%) patients. Within the premalignant group, intraductal papillary mucinous neoplasms (IPMNs) were the most common in 85% (47) patients. Cystic adenocarcinoma was the most prevalent malignant PCLs in 102 (83%) patients. Intra-cystic CEA value was the only parameter able to differentiate benign from malignant/premalignant lesions. Thirty (11%) patients underwent surgery with a final diagnosis of a malignant lesion in 13 (43%) patients, premalignant lesions in 5 (23%) (4 IPMNs and 1 mucinous cystadenoma) and benign cysts in 12 (40%). Five (38%) of the 13 malignant lesions were diagnosed at stages III/IV.</p><p><strong>Conclusion: </strong>Intra-cyst CEA values can help us to classify premalignant PCNs. However, additional biomarkers and clinical parameters are required to better discriminate patients at the time of PCLs detection.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398607","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":"Lessons from low-gluten challenge studies in celiac disease: Is it time to reconsider the gluten threshold in gluten-free food?","authors":"Carlo Catassi, Chiara Monachesi, Giulia N Catassi, Elena Lionetti","doi":"10.1016/j.dld.2025.01.202","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.202","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381643","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":"Variability in computer-aided detection effect on adenoma detection rate in randomized controlled trials: A meta-regression analysis.","authors":"Marco Spadaccini, Cesare Hassan, Yuichi Mori, Davide Massimi, Loredana Correale, Antonio Facciorusso, Harsh K Patel, Tommy Rizkala, Kareem Khalaf, Daryl Ramai, Emanuele Rondonotti, Roberta Maselli, Douglas K Rex, Pradeep Bhandari, Prateek Sharma, Alessandro Repici","doi":"10.1016/j.dld.2025.01.192","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.192","url":null,"abstract":"<p><strong>Background: </strong>Computer-aided detection (CADe) systems may increase adenoma detection rate (ADR) during colonoscopy. However, the variable results of CADe effects in different RCTs warrant investigation into factors influencing these results.</p><p><strong>Aims: </strong>Investigate the different variables possibly affecting the impact of CADe-assisted colonoscopy and its effect on ADR.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, and Scopus databases until July 2023 for RCTs reporting performance of CADe systems in the detection of colorectal neoplasia. The main outcome was pooled ADR. A random-effects meta-analysis was performed to obtain the pooled risk ratios (RR) with 95 % confidence intervals (CI)). To explore sources of heterogeneity, we conducted a meta-regression analysis using both univariable and multivariable mixed-effects models. Potential explanatory variables included factors influencing adenoma prevalence, such as patient gender, age, and colonoscopy indication. We also included both key (ADR), and minor (Withdrawal time) performance measures considered as quality indicators for colonoscopy.</p><p><strong>Results: </strong>Twenty-three randomized controlled trials (RCTs) on 19,077 patients were include. ADR was higher in the CADe group (46 % [95 % CI 39-52]) than in the standard colonoscopy group (38 % [95 % CI 31-46]) with a risk ratio of 1.22 [95 % CI 1.14-1.29]); and a substantial level of heterogeneity (I² = 67.69 %). In the univariable meta-regression analysis, patient age, ADR in control arms, and withdrawal time were the strongest predictors of CADe effect on ADR (P < .001). In multivariable meta-regression, ADR in control arms, and withdrawal time were simultaneous significant predictors of the proportion of the CADe effect on ADR.</p><p><strong>Conclusion: </strong>The substantial level of heterogeneity found appeared to be associated with variability in colonoscopy quality performances across the studies, namely ADR in control arm, and withdrawal time.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381801","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":"Innovative imaging for gastric cancer: Spectral CT and HRR.","authors":"Mengwei Shi, Liansheng Zheng, YueYang Li, Qingyu Ji","doi":"10.1016/j.dld.2025.01.204","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.204","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381715","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":"Metabolic dysfunction-associated steatotic liver disease as a predictor of cognitive performance: An 11-year population-based follow-up study.","authors":"Emilia Vataja, Matti Viitanen, Juha O Rinne, Jenni Lehtisalo, Iris Erlund, Tiia Ngandu, Seppo Koskinen, Fredrik Åberg, Antti Jula, Laura Ekblad","doi":"10.1016/j.dld.2025.01.197","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.197","url":null,"abstract":"<p><strong>Background: </strong>Prevalent manifestation of metabolic dysfunction, metabolic dysfunction-associated steatotic liver disease (MASLD), has been associated with poorer cognitive performance and greater decline in cognitive functions.</p><p><strong>Aim: </strong>The aim of this study was to analyze whether MASLD, measured by fatty-liver-index (FLI), predicts decline in cognitive performance during 11 years.</p><p><strong>Methods: </strong>This study was based on the Finnish nationwide, population-based Health 2000 Health Examination Survey and its follow-up, Health 2011 Survey. Cognitive performance was assessed with verbal fluency, word-list learning (WLL), delayed word-list recall (both at baseline and at follow-up), and with simple reaction time and visual choice reaction time tests (only at baseline). Statistical analyses were performed using multivariate linear regression adjusted for age, sex, education, APOE ε4 genotype, hypercholesterolemia, diabetes mellitus, hypertension, depressive symptoms, physical activity smoking status, C-reactive protein and HOMA of insulin resistance.</p><p><strong>Results: </strong>Cross-sectionally, 5,139 (mean age 52.3 years) and longitudinally, 3,143 (mean age 49.3 years) participants were examined. Cross-sectionally, no associations between FLI and cognitive performance were found in the adjusted models. Longitudinally, baseline FLI > 60 predicted poorer WLL (p < 0.005) and a decline in WLL from baseline to follow-up (p < 0.04).</p><p><strong>Conclusions: </strong>Our results suggest that MASLD is an independent predictor of decline in a test measuring working memory and learning.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373909","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":"Occupational Toxicants and their Impact on Metabolic Liver Disease.","authors":"Aimen Javed, Mahima Khatri, Satesh Kumar","doi":"10.1016/j.dld.2025.01.198","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.198","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370723","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":"Safety of same day discharge after Zenker's diverticulum peroral endoscopic myotomy.","authors":"Yara Sarkis, Mohammad Al-Haddad, Sarah Stainko, Laura Wreglesworth, Krista Ashcraft, John DeWitt","doi":"10.1016/j.dld.2025.01.188","DOIUrl":"https://doi.org/10.1016/j.dld.2025.01.188","url":null,"abstract":"<p><strong>Introduction: </strong>There are limited data on the safety of same-day discharge (SDD) following peroral endoscopic myotomy for Zenker's diverticulum (Z-POEM). Our aim is to assess the frequency and etiology of emergency department (ED) visits or hospital admissions after SDD after Z-POEM.</p><p><strong>Methods: </strong>Patients at our institution between 02/2020 and 08/2023 who had SDD after Z-POEM were identified. Criteria for SDD were: 1)no procedure-related serious adverse event; 2)post-POEM esophagram without leak; 3)stable vital signs; 4)ability to take liquids; 5)pain controlled without IV analgesia; 6)social support for transit to ED; 7)ASA class I-III. Relevant post-procedure events, ED visits and hospitalizations within 30 days were reported. A causative relationship between Z-POEM and ED visits and hospitalizations was assigned by consensus.</p><p><strong>Results: </strong>39 Z-POEMs were performed, and 26 (67 %) patients (58 % male, median age 72 years) had SDD. Mean ZD diameter was 29±14 mm and mean baseline Dakkak and Bennett's score was 2.9 ± 0.9. Within 30 days of Z-POEM, two(7.7 %) ED visits occurred 13 days and 9 days post-procedure for a COPD exacerbation(n = 1) and pneumonia(n = 1), respectively. Both patients were discharged without admission and only the visit for pneumonia was considered related to Z-POEM.</p><p><strong>Conclusion: </strong>Eligible patients who follow and fulfill a strict protocol after Z-POEM may be safely discharged the same day of the procedure.</p>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370724","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}