Digestive and Liver Disease最新文献

{"title":"Linking individuals’ risk perception and screening preferences: toward the introduction of personalized protocols","authors":"Carlo Senore , Tommy Rizkala , Cesare Hassan","doi":"10.1016/j.dld.2025.04.012","DOIUrl":"10.1016/j.dld.2025.04.012","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1160-1161"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981351","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":"Does the SCOPE (Sclerosing Cholangitis Outcomes in PEdiatrics) index effectively predict later liver transplantation in children with sclerosing cholangitis?","authors":"Ugo Cucinotta ,&nbsp;Valeria Dipasquale ,&nbsp;Claire Mayer ,&nbsp;Angela Alibrandi ,&nbsp;Bénédicte Pigneur ,&nbsp;Servane Avril ,&nbsp;Chiara Bergamo ,&nbsp;Rossella Morello ,&nbsp;Frank Rummele ,&nbsp;Claudio Romano ,&nbsp;Florence Lacaille","doi":"10.1016/j.dld.2025.03.021","DOIUrl":"10.1016/j.dld.2025.03.021","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>The SCOPE (Sclerosing Cholangitis Outcomes in Pediatrics) index was developed to provide the first pediatric prognostic score for primary sclerosing cholangitis (PSC), but its efficacy has yet to be confirmed. We aimed to assess its ability to predict liver transplantation (LT) over a 5-year follow-up.</div></div><div><h3>Methods</h3><div>We retrospectively included PSC-diagnosed patients under 18 years of age from two European tertiary-care centers. The SCOPE index was calculated at diagnosis and at 1, 3, and 5 years post-diagnosis. The ability of the SCOPE index to predict LT was assessed using multivariate Cox regression and ROC curve analysis.</div></div><div><h3>Results</h3><div>Sixty patients were included. In transplanted patients, the mean SCOPE index at diagnosis was similar to non-transplanted patients, but significantly higher at 1, 3, and 5 years post-diagnosis (<em>p</em> &lt; 0.001, <em>p</em> = 0.009, <em>p</em> = 0.006, respectively). Patients with overlapping autoimmune hepatitis (AIH) had higher SCOPE at diagnosis (<em>p</em> = 0.005), but this difference diminished over time. The SCOPE index was a significant predictor of LT at various time points (HRs: 1.32 to 3.44) and showed good-to-excellent discriminative power (AUC 0.87 at diagnosis; 0.97 at 1 year).</div></div><div><h3>Conclusions</h3><div>The SCOPE index effectively predicts LT in pediatric PSC, with strong reliability over time. Coexisting AIH may affect score accuracy at diagnosis due to inflammation.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1247-1253"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981643","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":"Utility of endoscopy in paediatric gastroenterology and hepatology–Review and updates","authors":"Mohana Sathiaseelan ,&nbsp;Tassos Grammatikopoulos","doi":"10.1016/j.dld.2025.01.199","DOIUrl":"10.1016/j.dld.2025.01.199","url":null,"abstract":"<div><div>Paediatric endoscopy has been an integral part of the diagnostic evaluation and management of gastroenterology and hepatology diseases in children. This area of clinical medicine has made meteoric advancements since it was first introduced conserving it's traditional roles of gastroscopy and colonoscopy but broadening significantly it's clinical utility and diagnostic accuracy with new and emerging technology. This article aims to explore and review the current utility and emerging applications of diagnostic and therapeutic endoscopy for the practicing paediatric gastroenterologist and hepatologist.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1119-1134"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536811","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":"Optimization of ustekinumab dosing in Crohn's disease: Addressing variability in treatment strategies and dosing evaluation","authors":"Shuyuan Wang,&nbsp;Lingkang Wu","doi":"10.1016/j.dld.2025.03.005","DOIUrl":"10.1016/j.dld.2025.03.005","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Page 1346"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778957","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":"Should we optimize treatment for Crohn's disease patients in clinical remission who do not achieve transmural response?","authors":"Federica Lepore ,&nbsp;Giovanni Cataletti ,&nbsp;Alessandro Massari ,&nbsp;Daniele Gridavilla ,&nbsp;Rosanna Cannatelli ,&nbsp;Giovanni Maconi","doi":"10.1016/j.dld.2025.04.002","DOIUrl":"10.1016/j.dld.2025.04.002","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1359-1360"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972653","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":"Correlation between serum thyroid hormone level and metabolic steatohepatitis: A retrospective study","authors":"Chun-Yan Yang ,&nbsp;Wei Guan ,&nbsp;Yan Liu ,&nbsp;Peng Zhang","doi":"10.1016/j.dld.2025.03.006","DOIUrl":"10.1016/j.dld.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic steatohepatitis (MASH) is a common liver disease, and its association with serum thyroid hormone levels is unclear. This study aimed to analyze the association between MASH and serum levels of thyroid hormones in patients with normal thyroid function.</div></div><div><h3>Methods</h3><div>638 non-alcoholic fatty liver disease patients hospitalized in our hospital from March 2021 to March 2024 were retrospectively selected and divided into MASH (<em>n</em> = 262) and non-MASH (<em>n</em> = 376) groups based on the diagnosis made by expert pathologists. The clinical data of the patients were collected, and multivariate logistic regression analysis was utilized to investigate the association between MASH and serum thyroid hormone levels.</div></div><div><h3>Results</h3><div>Serum levels of thyroid-stimulating hormone (TSH) and free triiodothyronine (FT3) in the MASH group were significantly higher compared to the non-MASH group, and serum free thyroxine (FT4) levels were lower than those in non-MASH group. The FT3/FT4 ratio in MASH group was higher than that in non-MASH group (<em>P</em> &lt; 0.05). Logistic regression analysis showed that serum levels of TSH, FT3 and FT4 were independent influencing factors for MASH. The area under receiver operating characteristic (ROC) curve of TSH, FT3, FT4 and FT3/FT4 for predicting the occurrence of MASH were 0.944, 0.973, 0.753 and 0.959, respectively.</div></div><div><h3>Conclusions</h3><div>Elevated serum levels of TSH, FT3, and the FT3/FT4 ratio, along with decreased serum FT4 levels, were independently associated with an increased risk of MASH.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1254-1259"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987483","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":"Deep sedation for gastrointestinal endoscopy in elderly patients. Subgroup analysis","authors":"Óscar Martínez-González ,&nbsp;M. Ángeles Alonso-Fernández ,&nbsp;Mónica García-Alonso ,&nbsp;Blanca López-Matamala ,&nbsp;Susana Soto-Fernández ,&nbsp;Carmen Martín-Parra ,&nbsp;Elena Marín-Alcolado ,&nbsp;Miriam Chana-García ,&nbsp;M. José Perez-Grueso ,&nbsp;Madian Manso-Álvarez ,&nbsp;María de Lucas-Gallego ,&nbsp;Ángela Algaba-Calderón ,&nbsp;Rafael Blancas","doi":"10.1016/j.dld.2024.11.029","DOIUrl":"10.1016/j.dld.2024.11.029","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal endoscopy is increasingly performed under sedation in older patients. Aging has implications in increasing the morbidity and the risk of complications related to sedation. The aim of this study is to assess the difference in complications between patients aged 65 to 74 years and those aged over 75 years.</div></div><div><h3>Materials and methods</h3><div>A prospective study was designed. Patients older than 65 years under deep sedation were included. Multivariate analysis was performed to assess complications in the propofol-sedated gastroscopy and propofol- and fentanyl-sedated colonoscopy groups.</div></div><div><h3>Results</h3><div>1,225 sedations were performed and 97.3 % of endoscopic procedures were completed. Desaturation occurred in 121 patients (9.9 %) with no significant differences between the two groups, 71 patients in the 65–74 age group and 50 in the ≥75 age group (9.2 % vs 10.9 %; <em>p</em> = 0.336). Major complications requiring intervention occurred in 68 patients (5.6 %), 46 in the 65–74 age group and 22 in the ≥75 age group (6.0 % vs 4.8 %; <em>p</em> = 0.385). Age contributed to the development of complications in gastroscopy under propofol sedation.</div></div><div><h3>Conclusions</h3><div>Complications of gastrointestinal endoscopy under deep sedation in patients older than 65 years are mostly not serious. Deep sedation in patients aged 75 years and older is not associated with more complications than in patients aged 65 to 74 years.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1266-1272"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876576","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 ,&nbsp;Cesare Hassan ,&nbsp;Yuichi Mori ,&nbsp;Davide Massimi ,&nbsp;Loredana Correale ,&nbsp;Antonio Facciorusso ,&nbsp;Harsh K. Patel ,&nbsp;Tommy Rizkala ,&nbsp;Kareem Khalaf ,&nbsp;Daryl Ramai ,&nbsp;Emanuele Rondonotti ,&nbsp;Roberta Maselli ,&nbsp;Douglas K. Rex ,&nbsp;Pradeep Bhandari ,&nbsp;Prateek Sharma ,&nbsp;Alessandro Repici ,&nbsp;the CADe Study group","doi":"10.1016/j.dld.2025.01.192","DOIUrl":"10.1016/j.dld.2025.01.192","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Aims</h3><div>Investigate the different variables possibly affecting the impact of CADe-assisted colonoscopy and its effect on ADR.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt; .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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1141-1148"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","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":"PSC-specific prognostic scores associated with graft loss and overall mortality in recurrent PSC after liver transplantation","authors":"Ellina Lytvyak ,&nbsp;Dennis Wang ,&nbsp;Devika Shreekumar ,&nbsp;Maryam Ebadi ,&nbsp;Yousef Alrifae ,&nbsp;Andrew Mason ,&nbsp;Aldo J. Montano-Loza","doi":"10.1016/j.dld.2025.02.001","DOIUrl":"10.1016/j.dld.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Primary sclerosing cholangitis (PSC) is a progressive liver disease with no treatment apart from liver transplantation (LT). After LT, patients can develop recurrent PSC (<em>r</em>PSC). The United-Kingdom (UK-PSC) and Amsterdam-Oxford (AOPSC) scores are used as prognostic models for PSC outcomes.</div></div><div><h3>Aim</h3><div>We aimed to assess these scores as predictive tools for graft loss and overall mortality in <em>r</em>PSC.</div></div><div><h3>Methods</h3><div>We evaluated 67 people who developed <em>r</em>PSC. Using Cox regression models, we quantified associations between UK-PSC and AOPSC scores and graft loss and overall mortality. Cut-offs were established using receiver operator characteristic analysis and the highest Youden index.</div></div><div><h3>Results</h3><div>Fifty-one individuals (76.1%) were males, with a mean age of 40±15 years. Both UK-PSC and AOPSC scores were independently associated with graft loss (hazard ratio [HR] 2.43 (<em>p</em> &lt; 0.001) and HR 3.45 (<em>p</em> &lt; 0.001), respectively), but only the UK-PSC score was independently associated with overall mortality (HR 2.63 (<em>p</em> = 0.009)). Individuals with UK-PSC ≥-4.2 (6.1 ± 0.8 vs. 14.7 ± 1.0 years; <em>p</em> = 0.001) and AOPSC ≥2.4 (5.4 ± 1.3 vs. 12.0 ± 1.1 years; <em>p</em> &lt; 0.001) had shorter graft survival.</div></div><div><h3>Conclusion</h3><div>UK-PSC score at <em>r</em>PSC predicts both graft loss and overall mortality, while AOPSC scores using either age at <em>r</em>PSC or at diagnosis along with severe cholestasis predict graft loss in people with <em>r</em>PSC. These easy-to-administer tools can be utilized in clinical practice to identify high-risk <em>r</em>PSC patients and guide decisions about monitoring/interventions.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1238-1246"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514960","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":"A case of recurrent pancreatitis was diagnosed as intraductal papillary mucinous neoplasm of the pancreas through MRCP and EUS","authors":"Yu-ling Xiong ,&nbsp;Chao Peng ,&nbsp;Yuan-lin Zhang ,&nbsp;Yue Tian","doi":"10.1016/j.dld.2025.02.013","DOIUrl":"10.1016/j.dld.2025.02.013","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"57 6","pages":"Pages 1325-1326"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639464","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}