Digestive DiseasesPub Date : 2024-01-01Epub Date: 2024-05-08DOI: 10.1159/000539210
Viktorija Basyte-Bacevice, Limas Kupcinskas
{"title":"Viral Hepatitis C: From Unraveling the Nature of Disease to Cure and Global Elimination.","authors":"Viktorija Basyte-Bacevice, Limas Kupcinskas","doi":"10.1159/000539210","DOIUrl":"10.1159/000539210","url":null,"abstract":"<p><strong>Background: </strong>The discovery of the hepatitis C virus (HCV) and direct-acting antiviral (DAA) drugs is one of the major milestones in the last 3 decades of medicine. These discoveries encouraged the World Health Organization (WHO) to set an ambitious goal to eliminate HCV by 2030, meaning \"a 90% reduction in new cases of chronic HCV, a 65% reduction in HCV deaths, and treatment of 80% of eligible people with HCV infections.\"</p><p><strong>Summary: </strong>This review summarizes the key achievements from the discovery of HCV to the development of effective treatment and global elimination strategies. A better understanding of HCV structure, enzymes, and lifecycle led to the introduction of new drug targets and the discovery of DAA. Massive public health interventions are required, such as screening, access to care, treatment, and post-care follow-up, to make the most of DAA's potential. Screening must be supported by fast, accessible, sensitive, specific HCV diagnostic tests and noninvasive methods to determine the stage of liver disease. Linkage to care and treatment access are critical components of a comprehensive HCV elimination program, and decentralization plays a key role in ensuring their effectiveness.</p><p><strong>Key messages: </strong>Effective and simple screening strategies, rapid diagnostic tools, linkage to health care, and accessible treatment are key elements to achieving the WHO's goal. Incorporating treatment as prevention strategies into elimination programs together with preventive education and harm reduction interventions can have a profound and lasting impact on reducing both the incidence and prevalence of HCV. However, WHO's goal can be challenging to implement because of the need for high financial resources and strong political commitment.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"486-495"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891083","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 Prognostic Model for Survival in Patients with Gastric Signet Ring Cell Carcinoma.","authors":"Xiao-Xiao Shao, Xi-Chen Li, Zi-Jian Lin, Ye-Jiao Ruan, Guang-Rong Lu, Wei-Zhong Wang, He Huang","doi":"10.1159/000536454","DOIUrl":"10.1159/000536454","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of our study was to develop a nomogram to predict overall survival (OS) and cancer-specific survival (CSS) in patients with gastric signet ring cell carcinoma (GSRCC).</p><p><strong>Methods: </strong>A total of 3,408 GSRCC patients between 1975 and 2017 were screened from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training and validation cohorts. Univariate and multivariate Cox analyses were conducted to identify independent prognostic factors for the construction of a nomogram. The performance of the model was then assessed by the concordance index (C-index), calibration plot, and area under the receiver operating characteristic curve (AUC). Then, the novel nomogram was further assessed by 64 GSRCC patients from our hospital as the external cohort.</p><p><strong>Results: </strong>We identified age, tumor lymph node metastasis (TNM) staging system, surgery, and chemotherapy as significant independent elements of prognosis. On this basis, a nomogram was constructed, with a C-index of OS in the training and validation cohorts of 0.763 (95% CI: 0.751-0.774) and 0.766 (95% CI: 0.748-0.784) and a C-index of CSS of 0.765 (95% CI: 0.753-0.777) and 0.773 (95% CI: 0.755-0.791), respectively. The AUCs of the nomogram for predicting 2- and 5-year OS were 0.848 and 0.885, respectively, and those for predicting CSS were 0.854 and 0.899, respectively, demonstrating the excellent predictive value of the constructed nomogram compared to the traditional AJCC staging system. Similar results were also observed in both the internal and external validation sets.</p><p><strong>Conclusion: </strong>The nomogram provided an accurate tool to predict OS and CSS in patients with GSRCC, which can assist clinicians in making predictions about individual patient survival.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"221-229"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717423","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}
Digestive DiseasesPub Date : 2024-01-01Epub Date: 2024-03-08DOI: 10.1159/000538079
Peter Malfertheiner, Christian Schulz, Richard H Hunt
{"title":"Helicobacter pylori Infection: A 40-Year Journey through Shifting the Paradigm to Transforming the Management.","authors":"Peter Malfertheiner, Christian Schulz, Richard H Hunt","doi":"10.1159/000538079","DOIUrl":"10.1159/000538079","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (H. pylori) was discovered 40 years ago and has set a milestone in human medicine. The discovery led to rejection of the dogma of the acidic stomach as a sterile organ and requested to rewrite the chapters on gastric pathophysiology and gastroduodenal diseases.</p><p><strong>Summary: </strong>Over a period of 40 years following the discovery, more than 50,000 articles can be retrieved in PubMed as of today and illustrate the amount and the intensity of research around the role of this bacterium. H. pylori emerged as cause of chronic gastritis and principal cause of peptic ulcer disease (PUD). Eradication of H. pylori became standard of care in management in PUD. The importance of this was highlighted in 2005 with the Nobel Prize in Medicine awarded to Barry Marshall and Robin Warren. H. pylori became eventually recognized for its oncogenic potential in the stomach and as the main risk factor for gastric cancer development.</p><p><strong>Key messages: </strong>H. pylori gastritis is defined as infectious disease and requires therapy in all infected individuals. Strategies of gastric cancer prevention and development of therapies to overcome the increasing antibiotic resistance are main targets in clinical research of today.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"299-308"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049003","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":"Linked Color Imaging with Artificial Intelligence Improves the Detection of Early Gastric Cancer.","authors":"Youshen Zhao, Osamu Dohi, Tsugitaka Ishida, Naohisa Yoshida, Tomoko Ochiai, Hiroki Mukai, Mayuko Seya, Katsuma Yamauchi, Hajime Miyazaki, Hayato Fukui, Takeshi Yasuda, Naoto Iwai, Ken Inoue, Yoshito Itoh, Xinkai Liu, Ruiyao Zhang, Xin Zhu","doi":"10.1159/000540728","DOIUrl":"10.1159/000540728","url":null,"abstract":"<p><strong>Introduction: </strong>Esophagogastroduodenoscopy is the most important tool to detect gastric cancer (GC). In this study, we developed a computer-aided detection (CADe) system to detect GC with white light imaging (WLI) and linked color imaging (LCI) modes and aimed to compare the performance of CADe with that of endoscopists.</p><p><strong>Methods: </strong>The system was developed based on the deep learning framework from 9,021 images in 385 patients between 2017 and 2020. A total of 116 LCI and WLI videos from 110 patients between 2017 and 2023 were used to evaluate per-case sensitivity and per-frame specificity.</p><p><strong>Results: </strong>The per-case sensitivity and per-frame specificity of CADe with a confidence level of 0.5 in detecting GC were 78.6% and 93.4% for WLI and 94.0% and 93.3% for LCI, respectively (p < 0.001). The per-case sensitivities of nonexpert endoscopists for WLI and LCI were 45.8% and 80.4%, whereas those of expert endoscopists were 66.7% and 90.6%, respectively. Regarding detectability between CADe and endoscopists, the per-case sensitivities for WLI and LCI were 78.6% and 94.0% in CADe, respectively, which were significantly higher than those for LCI in experts (90.6%, p = 0.004) and those for WLI and LCI in nonexperts (45.8% and 80.4%, respectively, p < 0.001); however, no significant difference for WLI was observed between CADe and experts (p = 0.134).</p><p><strong>Conclusions: </strong>Our CADe system showed significantly better sensitivity in detecting GC when used in LCI compared with WLI mode. Moreover, the sensitivity of CADe using LCI is significantly higher than those of expert endoscopists using LCI to detect GC.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"503-511"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893145","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":"Adverse Events after Different Endoscopic Resection Procedures for Small and Intermediate-Sized Colorectal Polyps.","authors":"Junki Toyosawa, Yasushi Yamasaki, Yuki Aoyama, Kensuke Takei, Shoko Igawa, Toshihiro Inokuchi, Hideaki Kinugasa, Masahiro Takahara, Sakiko Hiraoka, Hiroyuki Okada, Motoyuki Otsuka","doi":"10.1159/000540365","DOIUrl":"10.1159/000540365","url":null,"abstract":"<p><strong>Introduction: </strong>Cold snare polypectomy (CSP) and underwater endoscopic mucosal resection (UEMR) have been developed recently, in addition to conventional methods, but adverse events of each method have not been fully clarified. We compared the outcomes of each method for the appropriate choice.</p><p><strong>Methods: </strong>Patients who underwent CSP, endoscopic mucosal resection (EMR)/hot snare polypectomy (HSP), or UEMR for small and intermediate-sized colorectal polyps between April 2017 and June 2020 were retrospectively examined. The rate of adverse events and recurrences due to each method were determined as the main outcomes. Clinical factors related to adverse events were examined.</p><p><strong>Results: </strong>A total of 1,025 patients with 3,163 polyps underwent polypectomy using any of the methods. CSP, EMR/HSP, and UEMR were performed for 704 (22.2%), 2,145 (67.8%), and 314 polyps (9.9%), and the median size for each method was 4, 6, and 7 mm, respectively. Delayed bleeding for CSP, EMR/HSP, and UEMR was 0%, 0.2%, and 0.6% (p = 0.15), and perforation was 0%, 0.1%, and 0%, respectively (p = 0.62). Recurrence after CSP, EMR/HSP, and UEMR was 0.3%, 0.09%, and 1.3%, respectively (p < 0.01). Recurrence for UEMR was significantly higher in the early stage of procedure introduction (p = 0.015). Oral anticoagulants were the risk factor for delayed bleeding (p < 0.01, respectively).</p><p><strong>Conclusion: </strong>There was no significant difference regarding adverse events among each method for small and intermediate-sized polyps, although the recurrence rate after UEMR was higher than other methods.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"529-537"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916371","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}
Noor Bekkali, Georg Beyer, A. Gasbarrini, “Agostino, Hans-Dieter Allescher – Klinikum, Garmisch-Partenkirchen GmbH, Germany Marco, Del Chiaro, L. Eusebi, Abhai Verma, Sanjay Gandhi, L. Yue, R. H. Zhengzhou Zhang, S. Chen, G. Duan, K. Yamamoto, T. Ikeya, Y. Shiratori, Tokyo, F. Di Mario, X. Yang, C. Zhu, Y. Li, X.-L. Zuo, S.-W. Zhang, R. Xu, D. Chen, P. Cheng, Z. Li, Z. Fu, Q. Jian, R. Deng, Y. Ma, Guangzhou, D. Cao, H. Liu, L. Bai, H. Tang, L. Shi, S. Zhang, Macedo Silva, V. Freitas, Sousa Magalhães, Cúrdia Gonçalves, Boal Carvalho, P. Marinho, C. Cotter, L. Zhang, W. Zhao, B. Wang, W. J. Zhong, G. Hu, Z. Feng, W. Shen, G. Shao, Y. Hsu, KaohsiungTaipei
{"title":"Contents Vol. 41, 2023","authors":"Noor Bekkali, Georg Beyer, A. Gasbarrini, “Agostino, Hans-Dieter Allescher – Klinikum, Garmisch-Partenkirchen GmbH, Germany Marco, Del Chiaro, L. Eusebi, Abhai Verma, Sanjay Gandhi, L. Yue, R. H. Zhengzhou Zhang, S. Chen, G. Duan, K. Yamamoto, T. Ikeya, Y. Shiratori, Tokyo, F. Di Mario, X. Yang, C. Zhu, Y. Li, X.-L. Zuo, S.-W. Zhang, R. Xu, D. Chen, P. Cheng, Z. Li, Z. Fu, Q. Jian, R. Deng, Y. Ma, Guangzhou, D. Cao, H. Liu, L. Bai, H. Tang, L. Shi, S. Zhang, Macedo Silva, V. Freitas, Sousa Magalhães, Cúrdia Gonçalves, Boal Carvalho, P. Marinho, C. Cotter, L. Zhang, W. Zhao, B. Wang, W. J. Zhong, G. Hu, Z. Feng, W. Shen, G. Shao, Y. Hsu, KaohsiungTaipei","doi":"10.1159/000535573","DOIUrl":"https://doi.org/10.1159/000535573","url":null,"abstract":"","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"1202 2","pages":"I - IX"},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139019159","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}
Digestive DiseasesPub Date : 2023-06-01DOI: 10.1016/s0168-8278(23)03167-7
Yandi Xie, Minghui Li, X. Ou, S. Zheng, Yinjie Gao, Xiaoyuan Xu, Yingsi Yang, A. Ma, Jia Li, Y. Nan, Huan‐wei Zheng, Juan Liu, Lai Wei, B. Feng
{"title":"IP10 and anti-HBc can predict virological relapse and HBsAg loss in chronic hepatitis B patients after nucleos(t)ide analogue discontinuation.","authors":"Yandi Xie, Minghui Li, X. Ou, S. Zheng, Yinjie Gao, Xiaoyuan Xu, Yingsi Yang, A. Ma, Jia Li, Y. Nan, Huan‐wei Zheng, Juan Liu, Lai Wei, B. Feng","doi":"10.1016/s0168-8278(23)03167-7","DOIUrl":"https://doi.org/10.1016/s0168-8278(23)03167-7","url":null,"abstract":"","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"1 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48865025","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":"Uncovering the Silent Killer: Research highlights on chronic liver diseases.","authors":"Yao-Chun Hsu","doi":"10.1159/000530349","DOIUrl":"https://doi.org/10.1159/000530349","url":null,"abstract":"<p><p>Chronic liver disease (CLD) affects approximately 1.5 billion people around the world.1 Non-alcoholic fatty liver disease (NAFLD) is the most common CLD that accounts for 59% of prevalent cases, followed by hepatitis B virus (HBV) infection (29%) and hepatitis C virus infection (9%).2 CLD is a silent killer characterized by insidious progression in hepatic necroinflammation and fibrosis that can culminate in cirrhosis and increase the risk of primary liver cancer. According to the Global Burden of Disease study, there were 2.1 million deaths attributable to CLD in 2017, with cirrhosis and liver cancer respectively responsible for 62% and 38% of the mortality.3.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9553130","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":"Incidence and Mortality of Post-Polypectomy Colorectal Cancer in Patients with Low-Risk Adenomas: A Systematic Review and Meta-Analysis of Observational Studies.","authors":"Xiaoxiao Yang, Cheng Zhu, Yueyue Li, Yanqing Li, Xiuli Zuo","doi":"10.1159/000524138","DOIUrl":"https://doi.org/10.1159/000524138","url":null,"abstract":"<p><strong>Introduction: </strong>The long-term risks of post-polypectomy colorectal cancer (CRC) incidence and mortality among patients with low-risk adenomas (LRAs) are unclear. This study aimed to perform a systematic review and meta-analysis of the risk of CRC incidence and mortality following LRAs removal.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, and Cochrane library for studies that reported the risk of metachronous CRC incidence and mortality after colonoscopy. The primary outcome was the risk of CRC incidence and mortality in patients with LRAs. Random-effects models were used to calculate the pooled risk ratio (RR) with a 95% confidence interval (CI).</p><p><strong>Results: </strong>Thirteen observational studies with 1,750,305 patients (45.4% male; follow-up: 4.5-16.5 years) were included. A meta-analysis of seven studies showed a higher CRC incidence in patients with LRAs than those without adenomas (per 10,000 person-years: 5.2 vs. 3.9; RR 1.25 [95% CI 1.05-1.49], I2 = 0%). However, the CRC-related death rate was not significantly different between the two groups (RR 1.13 [95% CI 0.75-1.69], I2 = 0%). When compared with the general population, the meta-analysis showed a significantly lower risk of CRC incidence in patients with LRAs (RR 0.59 [95% CI 0.45-0.77], I2 = 0%), and another three studies, which could not be pooled, showed a reduction in the risk of CRC-related death in the LRAs group.</p><p><strong>Conclusions: </strong>Patients with LRAs have a small but higher risk of post-polypectomy CRC incidence than patients without adenomas. The marginally higher absolute incidence seemed insufficient for more intensive surveillance colonoscopy, but the significant difference suggested different follow-up strategies between patients with LRAs and those without adenomas.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 2","pages":"206-216"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9374818","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}
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