Digestive Diseases最新文献

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Onset Time and Characteristics of Postprocedural Bleeding after Endoscopic Resection of Colorectal Lesions: A Multicenter Retrospective Study. 内镜下结肠直肠病变切除术后出血的发生时间和特点:一项多中心回顾性研究。
IF 2.3 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2023-10-09 DOI: 10.1159/000534109
Qiyun Xiao, Maximilian Eckardt, Awsan Mohamed, Helmut Ernst, Alexander Behrens, Nils Homann, Thomas Hielscher, Georg Kähler, Matthias Ebert, Sebastian Belle, Tianzuo Zhan
{"title":"Onset Time and Characteristics of Postprocedural Bleeding after Endoscopic Resection of Colorectal Lesions: A Multicenter Retrospective Study.","authors":"Qiyun Xiao, Maximilian Eckardt, Awsan Mohamed, Helmut Ernst, Alexander Behrens, Nils Homann, Thomas Hielscher, Georg Kähler, Matthias Ebert, Sebastian Belle, Tianzuo Zhan","doi":"10.1159/000534109","DOIUrl":"10.1159/000534109","url":null,"abstract":"<p><strong>Introduction: </strong>Postprocedural bleeding is a major adverse event after endoscopic resection of colorectal lesions, but the optimal surveillance time after endoscopy is unclear. In this study, we determined onset time and characteristics of postprocedural bleeding events.</p><p><strong>Methods: </strong>We retrospectively screened patients who underwent endoscopic resection of colorectal lesions at three German hospitals between 2010 and 2019 for postprocedural bleeding events using billing codes. Only patients who required re-endoscopy were included for analysis. For identified patients, we collected demographic data, clinical courses, characteristics of colorectal lesions, and procedure-related variables. Factors associated with late-onset bleeding were determined by univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>From a total of 6,820 patients with eligible billing codes, we identified 113 cases with postprocedural bleeding after endoscopic mucosal (61.9%) or snare resection (38.1%) that required re-endoscopy. The median size of the culprit lesion was 20 mm (interquartile range 14-30 mm). The median onset time of postprocedural bleeding was day 3 (interquartile range: 1-6.5 days), with 48.7% of events occurring within 48 h. Multivariate logistic regression analysis demonstrates that a continued intake of antiplatelet drugs (OR: 3.98, 95% CI: 0.89-10.12, p = 0.025) and a flat morphology of the colorectal lesion (OR: 2.98, 95% CI: 1.08-8.01, p = 0.031) were associated with an increased risk for late postprocedural bleeding (&gt;48 h), whereas intraprocedural bleeding was associated with a decreased risk (OR: 0.12, 95% CI: 0.04-0.50, p = 0.001).</p><p><strong>Conclusion: </strong>Significant postprocedural bleeding can occur up to 18 days after endoscopic resection of colorectal lesions, but was predominantly observed within 48 h. Continued intake of antiplatelet drugs and a flat polyp morphology are associated with risk for late postprocedural bleeding.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"78-86"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182297","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}
引用次数: 0
Potential Risk Factors of Disorders of Gut-Brain Interaction in Undergraduates and Postgraduates: Partially Mediated by Life Stress and Lifestyle. 大学生和研究生肠脑互动失调的潜在风险因素:部分受生活压力和生活方式的影响。
IF 2 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2024-06-05 DOI: 10.1159/000539552
Likun Zhong, Yunxiao Liang, Huikuan Chu, Xiujing Zhang, Jingzhi Zhang, Xiaohua Hou, Zhiyue Xu
{"title":"Potential Risk Factors of Disorders of Gut-Brain Interaction in Undergraduates and Postgraduates: Partially Mediated by Life Stress and Lifestyle.","authors":"Likun Zhong, Yunxiao Liang, Huikuan Chu, Xiujing Zhang, Jingzhi Zhang, Xiaohua Hou, Zhiyue Xu","doi":"10.1159/000539552","DOIUrl":"10.1159/000539552","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the prevalence of disorders of gut-brain interaction (DGBI) and life stress in college students, and explore risk factors of DGBI in college students and the role of life stress.</p><p><strong>Methods: </strong>A total of 2,578 college students filled up validated questionnaires assessing GI symptoms, lifestyle, and life stress. Participants were diagnosed as DGBI based on the Rome III criteria. Multivariate ordinal logistic regression analysis and mediation effect model were employed to explore potential risk factors of DGBI and the mediating role of life stress and lifestyle in DGBI.</p><p><strong>Results: </strong>A total of 437 of 2,578 (17.0%) college students were diagnosed with DGBI. College students with DGBI had higher levels of life stress, including eight specific categories. Females (1.709 [1.437, 2.033]), staying up late (1.519 [1.300, 1.776]), and life stress (1.008 [1.006, 1.010]) were risk factors for DGBI, while postgraduates (0.751 [0.578, 0.976]) and regular diet (0.751 [0.685, 0.947]) were protective factors. Males and poor family economic were associated with a higher risk of DGBI after controlling stress, while an association between grade and DGBI was mediated by stress, regular diet, and sleep habits.</p><p><strong>Conclusion: </strong>DGBI was common among college students. Life stress and lifestyle were associated with DGBI and mediated partial association between grade and DGBI in college students. More attention should be paid to undergraduates.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"391-398"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261223","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}
引用次数: 0
Retraction Statement. 撤回声明。
IF 2 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2024-06-27 DOI: 10.1159/000539915
{"title":"Retraction Statement.","authors":"","doi":"10.1159/000539915","DOIUrl":"10.1159/000539915","url":null,"abstract":"","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"42 4","pages":"389"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476177","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}
引用次数: 0
Clinicopathological Features of Early Gastric Cancer Complicated by Autoimmune Gastritis. 自身免疫性胃炎并发早期胃癌的临床病理特征
IF 2 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2024-06-04 DOI: 10.1159/000539639
Kosuke Nomura, Daisuke Kikuchi, Yusuke Kawai, Yorinari Ochiai, Takayuki Okamura, Yugo Suzuki, Junnosuke Hayasaka, Yutaka Mitsunaga, Hiroyuki Odagiri, Satoshi Yamashita, Akira Matsui, Shu Hoteya
{"title":"Clinicopathological Features of Early Gastric Cancer Complicated by Autoimmune Gastritis.","authors":"Kosuke Nomura, Daisuke Kikuchi, Yusuke Kawai, Yorinari Ochiai, Takayuki Okamura, Yugo Suzuki, Junnosuke Hayasaka, Yutaka Mitsunaga, Hiroyuki Odagiri, Satoshi Yamashita, Akira Matsui, Shu Hoteya","doi":"10.1159/000539639","DOIUrl":"10.1159/000539639","url":null,"abstract":"<p><strong>Introduction: </strong>In the post-Helicobacter pylori era, autoimmune gastritis (AIG) is attracting increasing attention as an origin of gastric cancer. Here, we performed clinicopathological examination of gastric cancer complicating AIG treated in our hospital.</p><p><strong>Methods: </strong>Eighty-six early gastric cancer lesions complicating AIG in 50 patients were treated by endoscopic submucosal dissection (ESD) at our hospital in 2008-2022. Their clinicopathological characteristics were compared with those of a control group comprising 2,978 early gastric cancer lesions (excluding lesions in the remnant stomach after surgery) in 2,278 patients treated by ESD during the same period.</p><p><strong>Results: </strong>Mean age was significantly higher in the AIG group than in the control group (74.7 years vs. 70.9 years; p &lt; 0.01). In the respective groups, the occurrence rate of synchronous/metachronous lesions was 38.0% and 20.4% (p &lt; 0.01), the ratio of longitudinal cancer locations (upper/middle/lower third [U/M/L]) was 27/32/27 and 518/993/1,467 (p &lt; 0.01), the ratio of circumferential cancer locations (lesser curvature/greater curvature/anterior wall/posterior wall) was 25/31/12/18 and 1,259/587/475/657 (p &lt; 0.01), the ratio of major macroscopic types (I/IIa/IIb/IIc) was 13/38/5/30 and 65/881/220/1,812 (p &lt; 0.01). The rates of multiple gastric cancer and cancers in the U region, at the greater curvature, and of protruding types were significantly higher in the AIG group.</p><p><strong>Conclusion: </strong>The occurrence rate of multiple gastric cancer was significantly higher in gastric cancer complicating AIG (approximately 40%), and compared with the control group, the proportions of cancers at the U region, at the greater curvature, and of protruding types were significantly higher.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"407-413"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247602","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}
引用次数: 0
Adherence to the Mediterranean Diet Is Associated with Decreased Fecal Calprotectin Levels in Children with Crohn's Disease in Clinical Remission under Biological Therapy. 坚持地中海饮食与生物治疗下临床缓解期克罗恩病儿童粪便钙保护蛋白水平降低有关。
IF 2.3 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2023-12-01 DOI: 10.1159/000535540
Rotem Sigall Boneh, Amit Assa, Raffi Lev-Tzion, Manar Matar, Dror Shouval, Chen Shubeli, Tsachi Tsadok Perets, Gabriel Chodick, Raanan Shamir
{"title":"Adherence to the Mediterranean Diet Is Associated with Decreased Fecal Calprotectin Levels in Children with Crohn's Disease in Clinical Remission under Biological Therapy.","authors":"Rotem Sigall Boneh, Amit Assa, Raffi Lev-Tzion, Manar Matar, Dror Shouval, Chen Shubeli, Tsachi Tsadok Perets, Gabriel Chodick, Raanan Shamir","doi":"10.1159/000535540","DOIUrl":"10.1159/000535540","url":null,"abstract":"<p><strong>Introduction: </strong>Adherence to the Mediterranean diet (MD) was shown to be associated with decreased disease activity in adult patients with Crohn's disease (CD). Nevertheless, data on its association with fecal calprotectin (FC), particularly in children, remain limited. This study aimed to assess the association between adherence to the MD and FC as an indicator of mucosal healing in patients who are predominantly in remission while undergoing biological therapy.</p><p><strong>Methods: </strong>This was a cross-sectional study among children with CD. Adherence to MD was evaluated using both the KIDMED questionnaire and a food frequency questionnaire (FFQ). Israeli Mediterranean Diet Adherence Screener (I-MEDAS) score was calculated, and FC samples were obtained.</p><p><strong>Results: </strong>Of 103 eligible patients, 99 were included (mean age 14.3 ± 2.6 years; 38.4% females); 88% were in clinical remission, and 30% presented with elevated FC. The mean KIDMED score was higher among patients who had FC &lt;200 μg/g compared to patients with FC &gt;200 μg/g (5.48 ± 2.58 vs. 4.37 ± 2.47, respectively; p = 0.04). A moderate correlation between the KIDMED score and the I-MEDAS score was observed (r = 0.46; p = 0.001). In a multivariate regression analysis, adherence to MD was associated with decreased calprotectin levels, OR 0.75 [95% CI: 0.6-0.95], p = 0.019. Vegetable consumption was found to be inversely associated with elevated FC (0.9 portion/day [0.3-2.9] in FC &gt;200 μg/g vs. 2.2 portions/day [0.87-3.82] in FC &lt;200 μg/g; p = 0.049).</p><p><strong>Conclusions: </strong>In children with CD who are mostly in clinical remission under biological therapy, high adherence to MD is associated with decreased FC levels. Encouraging vegetable consumption, especially during remission, may benefit these patients.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"199-210"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138476935","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}
引用次数: 0
Inflammatory Bowel Disease: From Conventional Immunosuppression to Biologic Therapy. IBD:从传统免疫抑制到生物疗法。
IF 2 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2023-12-14 DOI: 10.1159/000535647
Aleksandra Sokic-Milutinovic, Tomica Milosavljevic
{"title":"Inflammatory Bowel Disease: From Conventional Immunosuppression to Biologic Therapy.","authors":"Aleksandra Sokic-Milutinovic, Tomica Milosavljevic","doi":"10.1159/000535647","DOIUrl":"10.1159/000535647","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases (IBDs) are chronic, recurrent inflammatory diseases with partly understood etiology and pathogenesis. The course of IBD, both ulcerative colitis and Crohn's disease, is characterized by periods of relapse and remission with the possible occurrence of extraintestinal manifestations.</p><p><strong>Summary: </strong>During the last decades, therapeutic goals in IBD evolved toward endoscopic remission and mucosal healing creating the need for early administration of disease-modifying agents (DMAs). DMAs include conventional immunosuppressants (thiopurines, methotrexate), biologic drugs (anti-TNF, anti-integrin, and anti-IL-12/23 monoclonal antibodies), and small molecules (JAK inhibitors, S1P receptor modulators). Patients with aggressive course of disease and risk factors for poor prognosis should be treated with biologic therapy early, while conventional immunomodulators should be used in those with milder course of disease in the absence of risk factors.</p><p><strong>Key messages: </strong>Challenges in the treatment of IBD patients include the choice of effective yet safe drug and prevention or overcoming loss of response.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"325-335"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801084","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}
引用次数: 0
Forty Years of Helicobacter pylori: The African Perspective. 幽门螺杆菌四十年:非洲视角》。
IF 2.3 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2023-12-21 DOI: 10.1159/000535263
Hyasinta Jaka, Stella Ifeanyi Smith
{"title":"Forty Years of Helicobacter pylori: The African Perspective.","authors":"Hyasinta Jaka, Stella Ifeanyi Smith","doi":"10.1159/000535263","DOIUrl":"10.1159/000535263","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori colonises 50% of the world population and is a causative agent of gastritis, peptic ulcer disease, mucosa associate lymphoid tissue lymphoma and gastric cancer.</p><p><strong>Summary: </strong>In Africa, the prevalence rate has been found to be the highest in comparison to other parts of the world. Despite its high prevalence there are low rates of gastric cancer recorded in Africa. This African perspective gives an insight into the history of H. pylori in Africa and also examines the issue of the so-called \"African Enigma,\" it's diagnosis and treatment and where we are now.</p><p><strong>Key messages: </strong>Our vision is to have an African community that is free from H. pylori infections and complications. To this end, the African Helicobacter and Microbiota Study Group was initiated in 2021 and launched on the June 27, 2022 in Lagos, Nigeria (<ext-link ext-link-type=\"uri\" xlink:href=\"https://ahmsg-africa.org/\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">https://ahmsg-africa.org/</ext-link>). The African perspective includes the need for more detailed information on actual community and hospital prevalence, resistance data, and standardizing processes and algorithms to enable comparative diagnosis and therapy of H. pylori infections using a multi-pronged approach with international support.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"161-165"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828745","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}
引用次数: 0
Diagnosis Value of the Blood Urea Nitrogen-to-Creatinine Ratio in Determining the Need for Intervention of Acute Upper Gastrointestinal Bleeding. 血尿素氮与肌酐比值对判断急性上消化道出血是否需要干预的诊断价值。
IF 2 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2024-03-26 DOI: 10.1159/000538366
Hong Liu, Yan Li, Chunliang Liu, Zheng Liu, Kailin Chen
{"title":"Diagnosis Value of the Blood Urea Nitrogen-to-Creatinine Ratio in Determining the Need for Intervention of Acute Upper Gastrointestinal Bleeding.","authors":"Hong Liu, Yan Li, Chunliang Liu, Zheng Liu, Kailin Chen","doi":"10.1159/000538366","DOIUrl":"10.1159/000538366","url":null,"abstract":"<p><strong>Introduction: </strong>The blood urea nitrogen (BUN)-to-creatinine (Cr) ratio (BUN/Cr ratio) may be used to evaluate the need for intervention of acute upper gastrointestinal bleeding (AUGIB). This study aimed to explore the predictive value of the BUN/Cr ratio in the need for intervention of AUGIB.</p><p><strong>Methods: </strong>This retrospective observational study included patients with AUGIB in the hospital's emergency department between August 2019 and May 2023. The patients were grouped according to whether they underwent an intervention for AUGIB. Patients treated between August 2019 and May 2022 were selected as the training set and the others as the validation set.</p><p><strong>Results: </strong>A total of 466 patients (328 males, 138 females) with AUGIB were enrolled in the intervention group (n = 167) and the no-intervention group (n = 299). In the training set, multivariable logistic regression showed that the BUN/Cr ratio (odds ratio [OR]: 1.013, 95% confidence interval [CI]: 1.003-1.023, p = 0.009), hemoglobin (OR: 0.989, 95% CI: 0.981-0.997, p = 0.010), and a previous history of esophageal variceal bleeding (OR: 6.898, 95% CI: 3.989-11.929, p &lt; 0.001) were independently associated with intervention for AUGIB. The area under receiver operating characteristic curve of BUN/Cr ratio and the prediction model based on logistic regression to predict the need for intervention of AUGIB were 0.604 (95% CI: 0.544-0.664) and 0.759 (95% CI: 0.706-0.812) in the training set and 0.634 (95% CI: 0.529, 0.740) and 0.708 (95% CI: 0.609, 0.806) in the validation set, respectively.</p><p><strong>Conclusion: </strong>The BUN/Cr ratio was associated with the need for AUGIB intervention. Combining it with other parameters might improve its diagnostic value to predict the need for intervention of AUGIB.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"285-291"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293099","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}
引用次数: 0
Mac-2-Binding Protein Glycosylation Isomer to Albumin Ratio Predicts Bacterial Infections in Cirrhotic Patients. Mac-2结合蛋白糖基化异构体与白蛋白比率可预测肝硬化患者的细菌感染。
IF 2.3 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2024-01-12 DOI: 10.1159/000535325
Pei-Shan Wu, Yun-Cheng Hsieh, Pei-Chang Lee, Tsung-Chieh Yang, Yu-Jen Chen, Ying-Ying Yang, Hui-Chun Huang, Shao-Jung Hsu, Teh-Ia Huo, Kuei-Chuan Lee, Han-Chieh Lin, Ming-Chih Hou
{"title":"Mac-2-Binding Protein Glycosylation Isomer to Albumin Ratio Predicts Bacterial Infections in Cirrhotic Patients.","authors":"Pei-Shan Wu, Yun-Cheng Hsieh, Pei-Chang Lee, Tsung-Chieh Yang, Yu-Jen Chen, Ying-Ying Yang, Hui-Chun Huang, Shao-Jung Hsu, Teh-Ia Huo, Kuei-Chuan Lee, Han-Chieh Lin, Ming-Chih Hou","doi":"10.1159/000535325","DOIUrl":"10.1159/000535325","url":null,"abstract":"<p><strong>Introduction: </strong>Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel biomarker for liver fibrosis, but little is known about its role in cirrhosis-associated clinical outcomes. This study aimed to investigate the predictive role of M2BPGi in cirrhosis-associated complications.</p><p><strong>Methods: </strong>One hundred and forty-nine cirrhotic patients were retrospectively enrolled. Patients were followed up for 1 year, and cirrhosis-associated clinical events were recorded. Receiver operating characteristic curve (ROC) analysis was used to establish the values of the predictive models for cirrhotic outcomes, and Cox proportional hazards regression models were used to identify predictors of clinical outcomes.</p><p><strong>Results: </strong>Sixty (40.3%) patients experienced cirrhosis-associated clinical events and had higher M2BPGi levels compared to those without events (8.7 vs. 5.1 cutoff index, p &lt; 0.001). The most common cirrhosis-associated complications were bacterial infections (24.2%). On ROC analysis, M2BPGi to albumin ratio (M2BPGi/albumin) had comparable discriminant abilities for all cirrhosis-associated events (area under the ROC curve [AUC] = 0.74) compared with M2BPGi, Child-Pugh, model for end-stage liver disease, albumin-bilirubin scores, and neutrophil-to-lymphocyte ratio and was superior to M2BPGi alone for all bacterial infectious events (AUC = 0.80). Cox regression analysis revealed that the M2BPGi/albumin, but not M2BPGi alone, independently predicted all cirrhosis-associated events (hazard ratio [HR] = 1.34, p = 0.038) and all bacterial infectious events (HR = 1.51, p = 0.011) within 1 year. However, M2BPGi/albumin did not predict other cirrhotic complications and transplant-free survival.</p><p><strong>Discussion/conclusion: </strong>M2BPGi/albumin might serve as a potential prognostic indicator for patients with cirrhosis, particularly for predicting bacterial infections.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"166-177"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466234","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}
引用次数: 0
Is Cholecystectomy Necessary after Choledocholithiasis Treatment for the Elderly or Patients with Many Comorbidities? 老年人或合并症较多的患者在胆总管结石治疗后是否有必要进行胆囊切除术?
IF 2 4区 医学
Digestive Diseases Pub Date : 2024-01-01 Epub Date: 2024-08-05 DOI: 10.1159/000540661
Masahiro Shiihara, Yasuhiro Sudo, Norimasa Matsushita, Takeshi Kubota, Yasuhiro Hibi, Harushi Osugi, Tatsuo Inoue
{"title":"Is Cholecystectomy Necessary after Choledocholithiasis Treatment for the Elderly or Patients with Many Comorbidities?","authors":"Masahiro Shiihara, Yasuhiro Sudo, Norimasa Matsushita, Takeshi Kubota, Yasuhiro Hibi, Harushi Osugi, Tatsuo Inoue","doi":"10.1159/000540661","DOIUrl":"10.1159/000540661","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated the prognosis after endoscopic treatment for choledocholithiasis, particularly in patients with borderline tolerance to surgery. Stone removal and cholecystectomy are generally recommended for patients with choledocholithiasis combined with gallstones to prevent recurrent biliary events. However, the prognosis after choledocholithiasis treatment in patients with borderline tolerance to surgery, such as the elderly or those with many comorbidities, remains controversial.</p><p><strong>Methods: </strong>We retrospectively analyzed data from patients with choledocholithiasis treated at our facility between January 2012 and December 2021. Patients who underwent endoscopic sphincterotomy were dichotomized into the cholecystectomy (CHOLE) and conservation (CONS) groups depending on whether cholecystectomy was performed, and their prognoses were subsequently compared. Furthermore, we performed a logistic regression analysis of the factors contributing to recurrent biliary events in patients with high age-adjusted Charlson Comorbidity Index (aCCI) scores.</p><p><strong>Results: </strong>Of 169 participants, 110 had gallstones and were divided into the CHOLE (n = 56) and CONS (n = 54) groups. The CONS group was significantly ordered, had more comorbidities, and higher aCCI scores, whereas the CHOLE group had fewer recurrent biliary events, although not significant (p = 0.122). No difference was observed in the recurrent incidence of grade ≥2 biliary infections and mortality related to biliary events between the groups. In patients with aCCI scores ≥5, conservation without cholecystectomy was not an independent risk factor for recurrent biliary events.</p><p><strong>Conclusion: </strong>Cholecystectomy after choledocholithiasis treatment prevents recurrent biliary events, but conservation without cholecystectomy is a feasible option for patients with high aCCI scores.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"576-582"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893144","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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