Digestive Diseases最新文献

{"title":"Comparison of Genetic Mutations of Gastric Cancer Diagnosed before or after Helicobacter pylori Eradication and between Differentiated and Undifferentiated Types Using Next-Generation Sequencing.","authors":"Masaaki Kodama, Manami Oda, Kazuhiro Mizukami, Ryo Ogawa, Yuka Hirashita, Masahide Fukuda, Kazuhisa Okamoto, Kensuke Fukuda, Takafumi Fuchino, Sotaro Ozaka, Tadayoshi Okimoto, Hisanori Abe, Kazumi Inaba, Masanori Tokoro, Keiko Arita, Hidefumi Nishikiori, Takashi Abe, Takayuki Nagai, Satoshi Yamashita, Kazunari Murakami","doi":"10.1159/000543645","DOIUrl":"10.1159/000543645","url":null,"abstract":"<p><strong>Introduction: </strong>Genetic abnormalities specific to post-Helicobacter pylori eradication gastric cancer (GC), especially those associated with undifferentiated post-eradication GC, are unknown. We conducted next-generation sequencing of GC diagnosed either before or after eradication to investigate the carcinogenesis of post-eradication GC.</p><p><strong>Methods: </strong>Five cases of post-eradication differentiated GC [HP(-)-D group], five cases of H. pylori-positive differentiated GC [HP(+)-D group], four cases of post-eradication undifferentiated GC [HP(-)-U group], and six cases of H. pylori-positive undifferentiated GC [HP(+)-U group] underwent analysis. DNA was extracted from tumor samples, and non-tumor samples of all subjects. Next-generation target sequencing was conducted using the Ion AmpliSeq Library Kit 2.0 with the Ion AmpliSeq Cancer Hotspot Panel v2. Next-generation targeted sequencing results of the cancer part were subtracted from the results of the non-cancer part.</p><p><strong>Results: </strong>The HP(-)-D group displayed significantly fewer SNPs in hotspot than the other groups (p < 0.01). Definitive DNA mutations were identified by sequencing of cancerous and non-cancerous tissues. 5 of 20 patients had specific somatic mutations, with different TP53 mutations in the HP(+)-D and HP(-)-U groups, CTNNB1 mutations in the HP(+)-U group, and ATM mutations in the HP(+)-U group, but no mutations in the HP(-)-D group.</p><p><strong>Conclusion: </strong>Several definite genetic mutations involved in GC were observed. Mutations were less frequent in post-eradication differentiated GC. However, because of small number of cases analyzed to identify carcinogenic differences, further analysis with a large number of cases and with strictly grading GC samples is needed.</p><p><strong>Introduction: </strong>Genetic abnormalities specific to post-Helicobacter pylori eradication gastric cancer (GC), especially those associated with undifferentiated post-eradication GC, are unknown. We conducted next-generation sequencing of GC diagnosed either before or after eradication to investigate the carcinogenesis of post-eradication GC.</p><p><strong>Methods: </strong>Five cases of post-eradication differentiated GC [HP(-)-D group], five cases of H. pylori-positive differentiated GC [HP(+)-D group], four cases of post-eradication undifferentiated GC [HP(-)-U group], and six cases of H. pylori-positive undifferentiated GC [HP(+)-U group] underwent analysis. DNA was extracted from tumor samples, and non-tumor samples of all subjects. Next-generation target sequencing was conducted using the Ion AmpliSeq Library Kit 2.0 with the Ion AmpliSeq Cancer Hotspot Panel v2. Next-generation targeted sequencing results of the cancer part were subtracted from the results of the non-cancer part.</p><p><strong>Results: </strong>The HP(-)-D group displayed significantly fewer SNPs in hotspot than the other groups (p < 0.01). Definitive DNA mutations we","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"158-169"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Endoscopic Features of Colorectal Non-Polypoid Lesions: A Single-Center Retrospective Study from a Large Cohort of Fecal Immunochemical Test-Positive Screening Patients in Northern Italy.","authors":"Alessandro Pezzoli, Francesco Buttitta, Caterina Palmonari, Marzia Simoni, Chiara Pierantoni, Alberto Merighi, Luigi Ricciardiello","doi":"10.1159/000543307","DOIUrl":"10.1159/000543307","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal non-polypoid lesions (NPLs) are flat, hard-to-detect, and mainly right-sided lesions. We aimed to assess the prevalence and endoscopic features of NPL lesions in a large cohort of screening patients in Northern Italy.</p><p><strong>Methods: </strong>Fecal immunochemical test (FIT)-positive subjects between 50 and 69 years old who had undergone at least a screening colonoscopy from March 2005 to December 2017 at the Endoscopy Unit of Ferrara were included. We selected only non-diminutive (>5 mm) and neoplastic polyps (i.e., adenomas, serrated adenomas, and carcinomas). Patients' demographics and polyps' endoscopic-histopathological data were collected. Categorical variables were compared using the Pearson's χ2 test and Fisher's exact test, while odd ratios and confidence intervals were estimated with univariate analysis.</p><p><strong>Results: </strong>A total of 6,676 FIT-positive subjects underwent 7,616 colonoscopies during the study period. Total lesions were 3,231, of which 133 were NPLs and among these 123 were neoplastic. The prevalence of NPLs among total lesions was 4.1%, while prevalence of neoplastic NPLs among total neoplastic lesions was 4.6%. The prevalence of NPLs and neoplastic NPLs among total colonoscopies was 1.7% and 1.6%, respectively. Neoplastic NPLs were more frequent between 60 and 64 years old (p = 0.03) and associated with other colonic polyps in subjects older than 60 years (p = 0.016). Cancerized NPLs were more likely in younger patients (50-59 years old, p = 0.04).</p><p><strong>Conclusions: </strong>Prevalence of NPLs is low among the screening population, but NPLs are frequently associated with other colorectal polyps in patients older than 60 years and carry a higher risk of cancer in patients younger than 60 years old.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"235-245"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001996","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":"Helicobacter pylori Infection Is Not Associated with Nonalcoholic Fatty Liver Disease: A Two-Year Cohort Study.","authors":"Huabo Zheng, Tangmeng Guo, Xiaofang Zhao, Kun Wang, Shengshuai Shan, Songpu Xie, Yichen Xu, Chengyun Liu, Weilin Lu","doi":"10.1159/000542180","DOIUrl":"10.1159/000542180","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies reported inconsistent results of the association between Helicobacter pylori infection and nonalcoholic fatty liver disease (NAFLD).</p><p><strong>Methods: </strong>A cohort study of 2,063 adults without NAFLD at baseline, who participated in a repeated health checkup including a 13C-urea breath test and abdominal ultrasonography, was conducted to evaluate the link between H. pylori infection and NAFLD development.</p><p><strong>Results: </strong>During a mean follow-up period of 1.7 years, we did not find a significant association between H. pylori infection and NAFLD (hazard ratio = 1.10 (0.86, 1.40), p = 0.4689). We also found that higher age, body mass index (BMI), systolic blood pressure (systolic BP), diastolic blood pressure (diastolic BP), fasting blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were risk factors, and high-density lipoprotein cholesterol (HDL-C) was a protective factor for NAFLD development.</p><p><strong>Conclusion: </strong>H. pylori infection might not be positively related to NAFLD development.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"75-83"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575596","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":"Disease Progression for Histologic Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease in the Real-World: A Nationwide US Study.","authors":"Xinrong Zhang, Leslie Yeeman Kam, Scott D Barnett, Linda Henry, Ramsey Cheung, Mindie H Nguyen","doi":"10.1159/000541945","DOIUrl":"10.1159/000541945","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;We compared clinical characteristics and outcomes in real-world metabolic dysfunction-associated steatotic liver disease (MASLD) patients with or without liver biopsy using a nationwide cohort in United States (USA) to fill in gaps in selection of biopsy patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study of adult MASLD patients using Marketscan® Databases (1/2007-12/2021). Patients were categorized into those with or without liver biopsy during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analyzed 540,326 MASLD patients: 23,732 with and 516,594 without biopsy. Only 4% of MASLD patients received liver biopsy and biopsy rate decreased in the last 5 years (9.4%-3.6%). After 1:5 propensity score matching on baseline characteristics including age, sex, and comorbidities, a total of 23,731 patients with biopsy and 118,396 matched patients without biopsy were analyzed. The incidence per 1,000 person-years for hepatocellular carcinoma (HCC) was 0.22 versus 2.18, cirrhosis 29.75 versus 90.44, and hepatic decompensation 15.84 versus 28.25 compared patients with and without biopsy. In multivariable analysis, patients with biopsy had more than 9 times higher risk of developing HCC, 3 times higher risk of cirrhosis, and 78% higher risk of hepatic decompensation. In subgroup analysis, the association remained consistent when stratified by age (&lt;50 and ≥50), sex, and diabetes mellitus. Predictors of having biopsy included age, metabolic diseases, and living in North central or Northeast of USA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These data can inform clinical patient management that biopsy patients likely represent a selected group at higher risk for disease progression, especially in clinical trials for MASLD therapies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;We compared clinical characteristics and outcomes in real-world metabolic dysfunction-associated steatotic liver disease (MASLD) patients with or without liver biopsy using a nationwide cohort in United States (USA) to fill in gaps in selection of biopsy patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study of adult MASLD patients using Marketscan® Databases (1/2007-12/2021). Patients were categorized into those with or without liver biopsy during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analyzed 540,326 MASLD patients: 23,732 with and 516,594 without biopsy. Only 4% of MASLD patients received liver biopsy and biopsy rate decreased in the last 5 years (9.4%-3.6%). After 1:5 propensity score matching on baseline characteristics including age, sex, and comorbidities, a total of 23,731 patients with biopsy and 118,396 matched patients without biopsy were analyzed. The incidence per 1,000 person-years for hepatocellular carcinoma (HCC) was 0.22 versus 2.18, cirrhosis 29.75 versus 90.44, and hepatic decompensation 15.84 versus 28.25 compared patients with and without biopsy. In multivariable analysis, patients w","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"36-45"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Colon Adenoma Detection Rate Using Transparent Cap-Assisted and Conventional Colonoscopy: Result from an International Trial in Asia.","authors":"Sakkarin Chirapongsathorn, Sho Suzuki, Panlert Prasanwon, Satimai Aniwan, Han-Mo Chiu, Kannikar Laohavichitra, Takeshi Yamamura, Chen-Ya Kuo, Naohisa Yoshida, Tiing Leong Ang, Takahito Takezawa, Rungsun Rerknimitr, Hideki Ishikawa, Takuji Gotoda","doi":"10.1159/000543296","DOIUrl":"10.1159/000543296","url":null,"abstract":"<p><strong>Introduction: </strong>Controversy remains regarding transparent cap-assisted technique improves adenoma detection rate (ADR) in colonoscopy. We aimed to investigate the effect of transparent cap-assisted colonoscopy (CAC) on ADR and other colonoscopy performance.</p><p><strong>Methods: </strong>We performed subanalysis of an international, multicenter, open-label database containing colonoscopy data from 11 centers in 4 Asian countries/regions on patients who underwent colonoscopy. The patient characteristics, procedure-related characteristics, and pathological findings of all detected lesions were prospectively recorded. The patients were divided into 2 groups as receiving colonoscopy with or without transparent cap attachment. The ADR and procedure time were compared between the 2 groups. Other procedural factors related to ADR were also investigated.</p><p><strong>Results: </strong>Between November 2020 and January 2022, 3,029 who underwent colonoscopy (transparent CAC, n = 1,796; standard colonoscopy, n = 1,233) were enrolled in this study. The transparent CAC group ADR was significantly higher than the conventional colonoscopy (55.1% vs. 50.0%, p < 0.01). Transparent CAC detected a higher proportion of patients with adenoma (odd ratio [OR]: 1.59, 95% CI: 1.13-2.24, p < 0.01) and any polypoid lesion (OR: 1.49, 95% CI: 1.04-2.16, p = 0.03). Transparent CAC also reduced cecal intubation time (mean difference: -0.35 min) and total colonoscopy time (mean difference -3.4 min). In the other procedural factors, using linked-color imaging (OR: 1.75, 95% CI: 1.49-2.06, p < 0.01), patient body rotation (OR: 1.54, 95% CI: 1.12-2.13, p < 0.01), longer withdrawal time (OR: 1.12, 95% CI: 1.09-1.15, p < 0.01) were also significantly associated to adenoma detection.</p><p><strong>Conclusion: </strong>In real-world practice, transparent CAC is a safe and inexpensive technology that could improve adenoma and polyp detection.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"215-224"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930926","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":"The Clinical Value of Serum Creatinine-to-Bilirubin Ratio in Predicting the Severity and Prognosis of Acute Pancreatitis.","authors":"Jun-Yi Chen, Jun-Lian He, Feng-Yi Feng, Xiao-Ya Yang, Wen-Rui Xie","doi":"10.1159/000541901","DOIUrl":"10.1159/000541901","url":null,"abstract":"<p><strong>Introduction: </strong>Bilirubin (BIL) and creatinine (Cr) have long been recognized as potential early indicators of disease severity. A recent study found that the Cr-to-BIL ratio (CTR) was more sensitive and specific than either serum Cr or BIL alone. Our research focused on the clinical significance of CTR in evaluating the severity and prognosticating outcomes of acute pancreatitis (AP) in patients.</p><p><strong>Methods: </strong>Patients diagnosed with AP at the First Affiliated Hospital of Guangdong Pharmaceutical University between July 1, 2016, and December 31, 2020 were included. The analysis then focused on examining the relationship between CTR levels and the severity of the illness, the occurrence of complications, and the prognosticating outcomes for individuals diagnosed with AP. A total of 286 AP patients were enrolled.</p><p><strong>Results: </strong>Multivariate regression analyses indicated that AP patients with elevated CTR levels were more likely to develop severe AP. They exhibited higher MODS, Ranson, and APACHE-II scores, an increased incidence of organ failures (acute heart failure [AHF], acute kidney injury [AKI], and acute myocardial infarction), higher 30-day all-cause mortality rates, and a worse prognosis, often requiring more frequent use of vasoactive and diuretic agents compared to those with lower CTR levels. When CTR >14.05, AP patients had increased occurrence of AHF and AKI, higher 30-day all-cause mortality rates, more frequently using vasoactive agent and diuretic agent. Besides, the disease severity scores (MODS, Ranson, and APACHE-II) and hospital stays were markedly increased.</p><p><strong>Conclusion: </strong>AP patients with elevated CTR levels are prone to more severe disease progression, increased complications, and poorer outcomes compared to those with lower CTR levels.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"115-124"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460446","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":"Intestinal Inflammation and Permeability in Patients Recovered from SARS-CoV-2 Infection.","authors":"Antonella Gallo, Celeste Ambra Murace, Michela Maria Corbo, Francesca Sarlo, Grazia De Ninno, Silvia Baroni, Giovanni Fancello, Luca Masucci, Marcello Covino, Matteo Tosato, Francesco Landi, Massimo Montalto","doi":"10.1159/000540381","DOIUrl":"10.1159/000540381","url":null,"abstract":"<p><strong>Introduction: </strong>Different works suggest a close link between long COVID gastrointestinal (GI) manifestations and the post-infection disorders of gut-brain interaction (PI-DGBIs). However, the actual mechanisms underlying long-term GI sequelae are still not clear. Our study was aimed to assess both intestinal inflammation and permeability among subjects recovered from SARS-CoV-2 infection and their eventual correlation with long-term GI sequelae.</p><p><strong>Methods: </strong>Eighty-six subjects attending the post-COVID service and recovered from SARS-CoV-2 infection for 6 months were investigated for long COVID manifestations. Those subjects complaining of long-term GI symptoms were further evaluated by Rome IV questionnaire to assess PI-DGBIs. Intestinal inflammation (by fecal calprotectin, FC) and permeability (by serum and fecal levels of zonulin) were evaluated in all subjects. The Hospital Anxiety and Depression Scale (HADS) and the Gastrointestinal Quality of Life Index (GIQLI) questionnaires were further provided to all participants.</p><p><strong>Results: </strong>Thirty-seven subjects (43%) complained of long-term GI symptoms, while 49 subjects (57%) did not. Thirty-three subjects fulfilled Rome IV criteria for PI-DGBIs. FC values resulted higher in those subjects who did not complain GI symptoms (p = 0.03), although remaining quite close to the normal range. No significant differences were shown regarding the assessment of intestinal permeability. By GIQLI, long-term GI sequelae were inversely correlated with quality of life (p = 0.009).</p><p><strong>Conclusion: </strong>Long COVID GI complaints unlikely recognize underlying local inflammatory mechanisms. Since the healthcare, economic, and social burden of post-COVID DGBIs, a deeper understanding of this emerging condition should be encouraged to improve management of the affected subjects.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380201","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":"Symptom Reporting in Patients with Primary Biliary Cholangitis: Higher Burden of Symptom Detection Using an Interactive App.","authors":"Jimmy Daza, Nathally Espinosa-Montagut, Achim Kautz, Diane Langenbacher, Michael Hetjens, Fabian Siegel, Matthias P Ebert, Andreas Teufel","doi":"10.1159/000543229","DOIUrl":"10.1159/000543229","url":null,"abstract":"<p><strong>Introduction: </strong>Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease causing bile duct destruction and inflammation, impacting patient's quality of life (QoL) due to variable symptoms. Digital symptom-tracker apps may improve patient care through enhanced monitoring. This study reassessed symptom burden in PBC patients using a tailored symptom-tracker app, focusing on its usability, effectiveness, and impact on management and QoL.</p><p><strong>Methods: </strong>Based on Kautz5 gUG \"Symptomtracker,\" our app in REDCap allowed users to log PBC symptoms over 4 weeks, alongside medication use. Ethics approval and data security complied with German regulations. User feedback was incorporated for better usability. Symptom data were standardized, and R software was used for descriptive statistics and Chi-square tests.</p><p><strong>Results: </strong>From March 2023 to October 2024, 210 patients (190 female, 20 male) were enrolled, median age 51 years. Among 90 patients who completed the questionnaire, fatigue was most prevalent (87.8%), followed by joint pain (80%), concentration difficulties (74.4%), abdominal discomfort (70%), and sicca symptoms. Other common symptoms were leg cramps (50%) and swollen feet (40%); jaundice was rare (7.8%). Older patients, especially those aged 50-60, reported a higher symptom burden, but Chi-square tests showed no significant differences across age or gender.</p><p><strong>Conclusion: </strong>This study highlights a significant symptom burden in PBC, particularly fatigue and joint pain. While older patients reported more symptoms, no significant differences were observed by age or gender. The symptom-tracker app enhanced monitoring and patient engagement, showing the potential of digital tools in PBC management. Further research is needed to evaluate long-term impacts.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"170-178"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983066","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":"Clinical Profiles of Leucine-Rich Alpha-2 Glycoprotein for Indicating Mucosal Healing in Ulcerative Colitis Patients under Administration of Molecular-Targeted Drug.","authors":"Satohiro Matsumoto, Hirosato Mashima","doi":"10.1159/000542062","DOIUrl":"10.1159/000542062","url":null,"abstract":"<p><strong>Introduction: </strong>Leucine-rich alpha-2 glycoprotein (LRG) is a useful serum biomarker for monitoring disease activity during remission in ulcerative colitis (UC). Because LRG levels differ among patients, it is necessary to assess them after profiling patients, especially in patients with refractory UC undergoing treatment with molecular-targeted drugs. This study aimed to analyze LRG levels that indicate mucosal healing according to clinical characteristics and molecular-targeted drugs.</p><p><strong>Methods: </strong>Among 214 patients with UC treated with biologics or Janus kinase (JAK) inhibitors, this study evaluated 111 patients (174 measurements) who achieved mucosal healing based on colonoscopy performed within 2 months before and after LRG measurement and experienced no changes in disease status or treatment during the same period. We analyzed the relationship of LRG with clinical characteristics (including sex, age, body mass index, and disease type and duration) and molecular-targeted drugs.</p><p><strong>Results: </strong>Compared with men, women had significantly higher LRG levels (9.5 μg/mL vs. 11.3 μg/mL, p < 0.001). In addition, LRG levels were significantly higher in older patients (12.0 μg/mL vs. 9.8 μg/mL, p < 0.01). LRG levels were the highest in patients treated with vedolizumab and lower in patients treated with JAK inhibitors (vedolizumab: 12.7 μg/mL; tofacitinib: 8.9 μg/mL; upadacitinib: 8.5 μg/mL; and filgotinib: 9.1 μg/mL; p < 0.0001).</p><p><strong>Conclusion: </strong>Among the patients who achieved mucosal healing, LRG levels were significantly higher in women and older patients. LRG levels differed according to the molecular-targeted drug used and were higher with vedolizumab and lower with JAK inhibitors.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"11-18"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496997","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":"Characteristics and Outcomes of Elderly Hepatocellular Carcinoma Patients following Surgical Resection: Systematic Review and Meta-Analysis.","authors":"Elizabeth M Garcia, Sanjna N Nerurkar, Eunice X Tan, Shaun Y S Tan, Ern-Wei Peck, Sabrina X Z Quek, Readon Teh, Margaret Teng, Andrew Tran, Ee Jin Yeo, Michael Le, Connie Wong, Ramsey Cheung, Daniel Q Huang","doi":"10.1159/000530101","DOIUrl":"10.1159/000530101","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26%, p = 0.11) and 5-year RFS (31.57% vs. 30.25%, p = 0.67) between non-elderly and elderly patients. There was a higher rate of minor complications (21.95% vs. 13.71%, p = 0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p = 0.43).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These data show that OS, recurrence, and major complications after liver resection for HCC are comparable between elderly and non-elderly patients and may inform clinical management of HCC in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Due to aging of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence-free survival (RFS), and complication rates in elderly HCC patients undergoing resection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched PubMed, Embase, and Cochrane databases from inception to November 10, 2020, for studies reporting outcomes in elderly (age ≥65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI: 72.89-76.02), 75.54% were male (95% CI: 72.53-78.32) and 66.73% had cirrhosis (95% CI: 43.93-83.96). The mean tumor size was 5.50 cm (95% CI: 4.71-6.29) and 16.01% had multiple tumors (95% CI: 10.74-23.19). The 1-year (86.02% vs. 86.66%, p = 0.84) and 5-year OS (51.60% vs. 53.78%) between non-elderly and elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% vs. 73.26","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"206-214"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}