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Impact of Functional Status on Development of Clostridioides difficile Infection and Increase in Inhospital Mortality among Antibiotic Users. 功能状态对抗生素使用者中艰难梭菌感染发展和住院死亡率增加的影响
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-11-23 DOI: 10.1159/000535306
Kenta Watanabe, Tsuyotoshi Tsuji, Yohei Saruta, Hisanori Matsuzawa, Yosuke Shimodaira, Katsunori Iijima
{"title":"Impact of Functional Status on Development of Clostridioides difficile Infection and Increase in Inhospital Mortality among Antibiotic Users.","authors":"Kenta Watanabe, Tsuyotoshi Tsuji, Yohei Saruta, Hisanori Matsuzawa, Yosuke Shimodaira, Katsunori Iijima","doi":"10.1159/000535306","DOIUrl":"10.1159/000535306","url":null,"abstract":"<p><strong>Introduction: </strong>Functional status is one of the surrogates of advanced age, an established risk factor for Clostridioides difficile infection (CDI). We aimed to investigate the usefulness of functional status in the clinical management of CDI.</p><p><strong>Methods: </strong>We enrolled all hospitalized adult patients receiving antibiotics from a retrospective hospital-based cohort in Japan between 2016 and 2020. Using the Barthel index (BI), which is an objective scale of functional status, we investigated the association of BI with developing CDI and its impact on inhospital mortality in patients with CDI.</p><p><strong>Results: </strong>We enrolled 17,131 patients with 100 cases of CDI. Multivariable analysis revealed that lower BI (≤25) was an independent risk factor for developing CDI (adjusted odds ratio, 4.11; 95% confidence interval, 2.62-6.46). Furthermore, a combination of BI and Charlson comorbidity index (CCI) showed an adjusted odds ratio of 36.40 (95% confidence interval, 17.30-76.60) in the highest risk group. A high-risk group according to the combination of BI and CCI was estimated to have significantly higher inhospital mortality in patients with CDI using the Kaplan-Meier method (p = 0.017). A combination of lower BI and higher CCI was an independent predictor of inhospital mortality even in the multivariable Cox regression model (adjusted hazard ratio, 3.00; 95% confidence interval, 1.01-8.88).</p><p><strong>Conclusions: </strong>Assessment of functional status, especially combined with comorbidities, was significantly associated with developing CDI and may also be useful in predicting inhospital mortality.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"131-139"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298687","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}
引用次数: 0
Prevalence and Risk Factors of Constipation Symptoms among Patients Undergoing Colonoscopy: A Single-Center Cross-Sectional Study. 结肠镜检查患者便秘症状的发生率和风险因素:一项单中心横断面研究。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-05-16 DOI: 10.1159/000539366
Shiori Komori, Junichi Akiyama, Naoko Tatsuno, Erika Yamada, Atsuko Izumi, Mariko Hamada, Kana Seto, Yuriko Nishiie, Keigo Suzuki, Yuya Hisada, Yuki Otake, Yuka Yanai, Hidetaka Okubo, Kazuhiro Watanabe, Naoki Akazawa, Natsuyo Yamamoto, Yasuo Tanaka, Mikio Yanase, Akiko Saito, Kazuhiko Yamada, Chizu Yokoi, Akihito Nagahara
{"title":"Prevalence and Risk Factors of Constipation Symptoms among Patients Undergoing Colonoscopy: A Single-Center Cross-Sectional Study.","authors":"Shiori Komori, Junichi Akiyama, Naoko Tatsuno, Erika Yamada, Atsuko Izumi, Mariko Hamada, Kana Seto, Yuriko Nishiie, Keigo Suzuki, Yuya Hisada, Yuki Otake, Yuka Yanai, Hidetaka Okubo, Kazuhiro Watanabe, Naoki Akazawa, Natsuyo Yamamoto, Yasuo Tanaka, Mikio Yanase, Akiko Saito, Kazuhiko Yamada, Chizu Yokoi, Akihito Nagahara","doi":"10.1159/000539366","DOIUrl":"10.1159/000539366","url":null,"abstract":"<p><strong>Introduction: </strong>Constipation is one of the most common gastrointestinal symptoms. It may compromise quality of life and social functioning and result in increased healthcare use and costs. We aimed to evaluate the prevalence and risk factors of constipation symptoms, as well as those of refractory constipation symptoms among patients who underwent colonoscopy.</p><p><strong>Methods: </strong>Over 4.5 years, patients who underwent colonoscopy and completed questionnaires were analyzed. Patients' symptoms were evaluated using the Gastrointestinal Symptoms Rating Scale.</p><p><strong>Results: </strong>Among 8,621 eligible patients, the prevalence of constipation symptoms was 33.3%. Multivariate analysis revealed female sex (odds ratio [OR] 1.7, p &lt; 0.001), older age (OR 1.3, p &lt; 0.001), cerebral stroke with paralysis (OR 1.7, p = 0.009), chronic renal failure (OR 2.6, p &lt; 0.001), ischemic heart disease (OR 1.3, p = 0.008), diabetes (OR 1.4, p &lt; 0.001), chronic obstructive pulmonary disease (OR 1.5, p = 0.002), benzodiazepine use (OR 1.7, p &lt; 0.001), antiparkinsonian medications use (OR 1.9, p = 0.030), and opioid use (OR 2.1, p = 0.002) as independent risk factors for constipation symptoms. The number of patients taking any medication for constipation was 1,134 (13.2%); however, refractory symptoms of constipation were still present in 61.4% of these patients. Diabetes (OR 1.5, p = 0.028) and irritable bowel syndrome (OR 3.1, p &lt; 0.001) were identified as predictors for refractory constipation symptoms.</p><p><strong>Conclusions: </strong>Constipation occurred in one-third of patients, and more than half of patients still exhibited refractory symptoms of constipation despite taking laxatives. Multiple medications and concurrent diseases seem to be associated with constipation symptoms.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"299-309"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Risk Factors for Post-Colorectal Endoscopic Submucosal Dissection Bleeding and Efficacy of Carbazochrome Sodium Sulfonate: A Multicenter Retrospective Cohort Study. 结直肠内镜黏膜下剥离术后出血的风险因素和卡氮磺酸钠的疗效:一项多中心回顾性队列研究。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-05-22 DOI: 10.1159/000539367
Keitaro Takahashi, Takuya Iwama, Kazuyuki Tanaka, Yuki Miyazawa, Shohei Kuroda, Masashi Horiuchi, Seisuke Saito, Momotaro Muto, Aki Sakatani, Katsuyoshi Ando, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Toshikatsu Okumura, Mikihiro Fujiya
{"title":"Risk Factors for Post-Colorectal Endoscopic Submucosal Dissection Bleeding and Efficacy of Carbazochrome Sodium Sulfonate: A Multicenter Retrospective Cohort Study.","authors":"Keitaro Takahashi, Takuya Iwama, Kazuyuki Tanaka, Yuki Miyazawa, Shohei Kuroda, Masashi Horiuchi, Seisuke Saito, Momotaro Muto, Aki Sakatani, Katsuyoshi Ando, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Toshikatsu Okumura, Mikihiro Fujiya","doi":"10.1159/000539367","DOIUrl":"10.1159/000539367","url":null,"abstract":"<p><strong>Introduction: </strong>Carbazochrome sodium sulfonate (CSS) is a hemostatic agent that reduces capillary permeability and enhances capillary resistance. However, its specific effects on colorectal endoscopic submucosal dissection (ESD) outcomes remain uncertain. This study aimed to assess the risk factors for post-ESD bleeding and the effect of CSS on colorectal ESD outcomes.</p><p><strong>Methods: </strong>First, we retrospectively analyzed the risk factors for post-ESD bleeding using data from 1,315 lesions in 1,223 patients who underwent ESD for superficial colorectal neoplasms at eight institutions. Second, patients were divided into CSS and non-CSS groups using propensity score matching, and their outcomes from colorectal ESD were analyzed.</p><p><strong>Results: </strong>The risk factors for post-colorectal ESD bleeding were identified as age of ≥70 years, tumor located in the rectum, tumor size of ≥40 mm, and post-ESD defect unclosure in both univariate and multivariate analyses. The CSS and non-CSS groups each consisted of 423 lesions after propensity score matching. The post-colorectal ESD bleeding rate was 3.5% (15/423) and 3.3% (14/423) in the CSS and non-CSS groups, respectively, indicating no significant differences. Among patients with the high-risk factors for post-ESD bleeding, the administration of CSS also did not demonstrate a significant reduction in the post-ESD bleeding rate compared to the non-CSS group.</p><p><strong>Conclusion: </strong>CSS administration is ineffective in preventing post-colorectal ESD bleeding in both the general population and individuals at a high risk for such bleeding. Our results indicate the necessity to reconsider the application of CSS for preventing post-colorectal ESD bleeding.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"310-319"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Efficacy and Safety of STW 5-II for Functional Dyspepsia Treatment: A Patient Data-Based Meta-Analysis. STW 5-II 治疗功能性消化不良的有效性和安全性:基于患者数据的荟萃分析。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000535672
Viola Andresen, Ayesha Shah, Careen Fink, Sabine Rabini, Manfred Wargenau, Gerald Holtmann
{"title":"Efficacy and Safety of STW 5-II for Functional Dyspepsia Treatment: A Patient Data-Based Meta-Analysis.","authors":"Viola Andresen, Ayesha Shah, Careen Fink, Sabine Rabini, Manfred Wargenau, Gerald Holtmann","doi":"10.1159/000535672","DOIUrl":"10.1159/000535672","url":null,"abstract":"<p><strong>Introduction: </strong>Functional dyspepsia (FD) is a chronic relapsing gastroduodenal disorder with limited treatment options. Herbal products, like the six-herb combination STW 5-II, can target multiple FD gastrointestinal symptoms. In this meta-analysis, we evaluated the efficacy and safety of STW 5-II for overall FD, and key symptoms, based on Rome IV criteria.</p><p><strong>Methods: </strong>We systematically screened the literature for randomized controlled clinical studies testing STW 5-II in FD. Meta-analysis was performed using data from individual patients with at least one key FD symptom (fullness, early satiety, or epigastric pain) of at least moderate severity at baseline. ANCOVA-based meta-analyses were performed on improvements in the total symptom sum score, and single symptoms, after 4 and 8 weeks. Safety data were analyzed by calculating odds ratios for all adverse events.</p><p><strong>Results: </strong>Four randomized controlled trials, including 613 patients, were identified, and two were eligible for efficacy analysis. STW 5-II significantly improved the FD symptom sum score (mean difference of 1.74 after 4 weeks and 2.07 after 8 weeks) and key FD symptoms of fullness (0.28 and 0.29), early satiety (0.25 and 0.26), and epigastric/upper abdominal pain (0.26 and 0.3). Treatment-related or severe adverse events did not differ between STW 5-II and placebo.</p><p><strong>Conclusion: </strong>The results support that STW 5-II significantly improves FD symptoms after 4 and 8 weeks of treatment with no difference in relation to safety signals compared to placebo. Thus, STW 5-II can be considered an effective and safe treatment option for FD.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"166-174"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Functional Dyspepsia: Current Understanding and Future Perspective. 功能性消化不良:当前认识与未来展望。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-08-18 DOI: 10.1159/000532082
Tadayuki Oshima
{"title":"Functional Dyspepsia: Current Understanding and Future Perspective.","authors":"Tadayuki Oshima","doi":"10.1159/000532082","DOIUrl":"10.1159/000532082","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is a common disorder characterized by chronic or recurrent upper abdominal pain or discomfort without any structural abnormalities in the gastrointestinal tract. FD is categorized into two subgroups based on symptoms: postprandial distress syndrome (PDS) and epigastric pain syndrome.</p><p><strong>Summary: </strong>The pathophysiology of FD involves several mechanisms. Delayed gastric emptying is observed in approximately 30% of FD patients but does not correlate with symptom patterns or severity. Impaired gastric accommodation is important in the pathophysiology, particularly for PDS. Visceral hypersensitivity, characterized by heightened sensitivity to normal activities, contributes to the perception of discomfort or pain in FD. Alterations to the duodenal mucosa, including impaired mucosal barrier function and low-grade inflammation, are also implicated in the pathogenesis of FD. Microbial dysbiosis and psychological factors such as stress can further exacerbate symptoms. Treatment options include dietary modifications, establishing a physician-patient relationship, acid suppressants, prokinetics, neuromodulators, and behavioral therapies. Dietary recommendations include eating smaller, more frequent meals, and avoiding trigger foods. Acid suppressants are used as the first-line treatment. Prokinetics and neuromodulators aim to improve gastric motility and central pain processing, respectively. Behavioral therapies, including cognitive behavioral therapy and hypnotherapy, have shown benefits for refractory FD. Severe and refractory cases may require combination therapies or experimental treatments.</p><p><strong>Key messages: </strong>FD is a disorder of gut-brain interaction involving diverse pathophysiological mechanisms. Individualized treatment based on symptoms and responses to interventions is crucial. Further research is needed to improve the understanding of FD and advance the development of effective therapies.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"26-33"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031061","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}
引用次数: 0
Esophageal Motility Disorders: Diagnosis and Treatment Strategies. 食管运动障碍:诊断与治疗策略。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-08-25 DOI: 10.1159/000533347
Yoshimasa Hoshikawa, Katsuhiko Iwakiri
{"title":"Esophageal Motility Disorders: Diagnosis and Treatment Strategies.","authors":"Yoshimasa Hoshikawa, Katsuhiko Iwakiri","doi":"10.1159/000533347","DOIUrl":"10.1159/000533347","url":null,"abstract":"<p><strong>Background: </strong>Esophageal motility disorders (EMDs) are caused by the impaired relaxation of the upper/lower esophageal sphincter and/or defective esophageal peristaltic contractions, resulting in dysphagia and noncardiac chest pain. High-resolution manometry (HRM) is essential for the diagnosis of primary EMD; however, the recognition of EMD and HRM by general practitioners in Japan is limited. This review summarizes the diagnosis of and treatment strategies for EMD.</p><p><strong>Summary: </strong>HRM is a specific test for the diagnosis of EMD, whereas endoscopy and barium swallow as screening tests provide characteristic findings (i.e., esophageal rosette and bird's beak sign) in some cases. It is important to note that manometric diagnoses apart from achalasia are often clinically irrelevant; therefore, the recently updated guidelines suggest additional manometric maneuvers, such as the rapid drink challenge, and further testing, including functional lumen imaging, for a more accurate diagnosis before invasive treatment. Endoscopic/surgical myotomy, pneumatic dilation, and botulinum toxin injections need to be considered for patients with achalasia and clinically relevant esophagogastric junction outflow obstruction.</p><p><strong>Key message: </strong>Since the detailed pathophysiology of EMD remains unclear, their diagnosis needs to be cautiously established prior to the initiation of invasive treatment.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"11-17"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458701","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}
引用次数: 0
Analysis of the Medication Persistence Rate for and Adherence to Oral 5-Aminosalicylic Acid Preparations in Japanese Patients with Ulcerative Colitis: Study Using a Nationwide Claims Database. 日本溃疡性结肠炎患者口服 5-氨基水杨酸制剂的用药持续率和依从性分析:使用全国索赔数据库进行的研究。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-03-25 DOI: 10.1159/000538319
Takumi Ota, Takahiro Takebe, Yutaka Shimizu, Takashi Orido, Hiroyuki Tanaka, Shiro Nakamura
{"title":"Analysis of the Medication Persistence Rate for and Adherence to Oral 5-Aminosalicylic Acid Preparations in Japanese Patients with Ulcerative Colitis: Study Using a Nationwide Claims Database.","authors":"Takumi Ota, Takahiro Takebe, Yutaka Shimizu, Takashi Orido, Hiroyuki Tanaka, Shiro Nakamura","doi":"10.1159/000538319","DOIUrl":"10.1159/000538319","url":null,"abstract":"<p><strong>Introduction: </strong>5-aminosalicylic acid (5-ASA) is the first-line drug for the treatment of mild-to-moderate ulcerative colitis (UC). Three oral sustained-release formulations are often used. However, no unified view of their actual use in routine medical practice has been presented to date.</p><p><strong>Methods: </strong>Using a health insurance claims database, we extracted patients with an initial diagnosis of mild-to-moderate UC during the period from December 1, 2017, to March 31, 2022. For the three types of oral 5-ASA formulation, we calculated and compared descriptive statistics of medication persistence rates (MPR), proportions of days covered (PDC), and adherence proportion (PDC ≥80%) in the extracted population.</p><p><strong>Results: </strong>An oral 5-ASA formulation was used in combination with a topical preparation (cohort 1) in 899 patients, and oral 5-ASA was used alone (cohort 2) in 1,829 patients. In cohort 1, MPR at days 151-180 with concomitant use of topical formulation was significantly higher for the Multi Matrix System™ (MMX) formulation (65.2%) compared with that for pH-dependent formulation (51.7%, p &lt; 0.025), while MPR tended to be higher for MMX than for the time-dependent formulation (56.4%, not significant). During days 151-180 after starting the oral formulation, MPR for MMX (66.7% and 65.8%) was higher than for pH-dependent (55.9% and 55.3%) and time-dependent (57.6% and 55.9%) formulations in cohorts 1 + 2 and 2, respectively. In cohort 1, there was a significant difference between MMX (68.3%) and pH-dependent (57.1%) formulations, but no significant difference was seen with time-dependent formulations (61.8%). In terms of the proportion of adherence until day 180, MMX was significantly better than the other formulations.</p><p><strong>Conclusion: </strong>The analyses of the three oral 5-ASA formulations suggested that both MPR and medication adherence were better for the MMX formulation than for time-dependent or pH-dependent formulations.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"232-242"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Clinical Impact of Proton Pump Inhibitor and Potassium-Competitive Acid Blocker for Predicting the Curability of Endoscopic Resection in Ulcerative Early Gastric Cancer. 质子泵抑制剂和钾竞争性酸阻滞剂对预测溃疡性早期胃癌内镜切除术治愈率的临床影响。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-02-02 DOI: 10.1159/000536617
Konomu Uno, Takaya Shimura, Shingo Inaguma, Keita Kuroyanagi, Ruriko Nishigaki, Takuya Kanno, Makiko Sasaki, Shigeki Fukusada, Naomi Sugimura, Yusuke Mizuno, Takayuki Nukui, Yuki Kojima, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Satoru Takahashi, Hiromi Kataoka
{"title":"Clinical Impact of Proton Pump Inhibitor and Potassium-Competitive Acid Blocker for Predicting the Curability of Endoscopic Resection in Ulcerative Early Gastric Cancer.","authors":"Konomu Uno, Takaya Shimura, Shingo Inaguma, Keita Kuroyanagi, Ruriko Nishigaki, Takuya Kanno, Makiko Sasaki, Shigeki Fukusada, Naomi Sugimura, Yusuke Mizuno, Takayuki Nukui, Yuki Kojima, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Satoru Takahashi, Hiromi Kataoka","doi":"10.1159/000536617","DOIUrl":"10.1159/000536617","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic diagnosis is essential for predicting the curability of early gastric cancer (EGC; R0 resection) before treatment, but the relationship between ulcerative lesions and clinical outcomes remains unclear. We aimed to investigate the effect of proton pump inhibitor (PPI) or potassium-competitive acid blocker (P-CAB) on the morphological changes of ulcerative EGCs and its relevance to the clinical outcomes.</p><p><strong>Methods: </strong>Altogether, 143 patients with differentiated ulcerative EGC that were resected by endoscopic submucosal dissection were retrospectively identified and divided into the following two cohorts depending on their PPI/P-CAB administration status: PPI/P-CAB (n = 76) and non-PPI/P-CAB (n = 67) cohorts. Furthermore, in each cohort, the patients were further divided into the improved and unimproved subgroups based on the ulcerative changes.</p><p><strong>Results: </strong>In the PPI/P-CAB cohort, the deep submucosal invasion and lymphovascular invasion rates were significantly higher in the unimproved subgroup than in the improved subgroup, resulting in a significantly lower R0 resection rate. Contrarily, no significant differences were found between the two subgroups in the non-PPI/P-CAB cohort. The significance of PPI/P-CAB administration was observed only in the ulcerative EGCs with open-type atrophy (R0 resection rate; improved vs. unimproved, 90.9% vs. 48.0%, p = 0.001). When the finding of improved ulcer with PPI/P-CAB administration was used as the indication of endoscopic resection in ulcerative EGCs with open-type atrophy, high sensitivity (78.9%) and accuracy (76.3%) rates for the curability were observed, which were higher than those of conventional endoscopic diagnosis alone (p = 0.021).</p><p><strong>Conclusion: </strong>PPI or P-CAB administration might contribute to the potential selection of ulcerative EGCs, enabling endoscopic curative resection.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"192-200"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680890","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}
引用次数: 0
Classification of Colorectal Cancer Subtypes Based on Endoplasmic Reticulum Stress. 基于内质网应激的结直肠癌亚型分类。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-11-23 DOI: 10.1159/000535230
Zhanbo Qu, Jian Chu, Yinhang Wu, Jing Zhuang, Jiang Liu, Shugao Han, Wei Wu, Shuwen Han
{"title":"Classification of Colorectal Cancer Subtypes Based on Endoplasmic Reticulum Stress.","authors":"Zhanbo Qu, Jian Chu, Yinhang Wu, Jing Zhuang, Jiang Liu, Shugao Han, Wei Wu, Shuwen Han","doi":"10.1159/000535230","DOIUrl":"10.1159/000535230","url":null,"abstract":"<p><strong>Introduction: </strong>Endoplasmic reticulum stress (ERS) is associated with the occurrence and development of colorectal cancer (CRC).</p><p><strong>Methods: </strong>One thousand nine CRC samples and 3 ERS gene sets from GEO database were used to screen and validate genes related to stage and prognosis of CRC. Twenty thousand five hundred thirty samples from the TCGA database validated the ERS genes related to prognosis. PPI network construction and coexpression analysis were used to investigate the correlation of genes. ConsensusClusterPlus analysis was used to classify CRC subtypes. Cox regression and the LASSO algorithm were used to screen ERS genes related to prognosis. HE staining, immunohistochemical staining, and RT-qPCR of 50 owner-central samples were used to verify the genes. The ERscore model was constructed based on the ERS genes related to prognosis. The nomogram model was used to verify that different subtypes of CRC patients have different prognosis.</p><p><strong>Results: </strong>Fifty ERS differentially expressed genes related to CRC stage and 8 ERS model genes related to prognosis were screened. Three subtypes of CRC were classified based on the former 50 genes. The clinical characteristics were significantly different among the subtypes. The ERscore model was constructed based on the latter 8 genes, and its accuracy was verified by clinical samples. Finally, the nomogram was constructed based on ERscore, age, and CRC stage, and the accuracy of the nomogram prediction was verified.</p><p><strong>Conclusion: </strong>ERS-related genes can be used as classification criteria for CRC, and the related clinical characteristics of different CRC subtypes are different.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"107-130"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298686","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}
引用次数: 0
Analysis of Neuropeptides in the Intestinal Mucus of Patients with Ulcerative Colitis Using RNA Sequencing. 利用 RNA 测序分析溃疡性结肠炎患者肠粘液中的神经肽
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-07-20 DOI: 10.1159/000540052
Masanao Nakamura, Kentaro Murate, Keiko Maeda, Takeshi Yamamura, Tsunaki Sawada, Eri Ishikawa, Kazuhiro Furukawa, Takashi Hirose, Kota Uetsuki, Tadashi Iida, Yasuyuki Mizutani, Kentaro Yamao, Yoji Ishizu, Takuya Ishikawa, Takashi Honda, Hiroki Kawashima
{"title":"Analysis of Neuropeptides in the Intestinal Mucus of Patients with Ulcerative Colitis Using RNA Sequencing.","authors":"Masanao Nakamura, Kentaro Murate, Keiko Maeda, Takeshi Yamamura, Tsunaki Sawada, Eri Ishikawa, Kazuhiro Furukawa, Takashi Hirose, Kota Uetsuki, Tadashi Iida, Yasuyuki Mizutani, Kentaro Yamao, Yoji Ishizu, Takuya Ishikawa, Takashi Honda, Hiroki Kawashima","doi":"10.1159/000540052","DOIUrl":"10.1159/000540052","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammation in ulcerative colitis (UC) originates in the colorectal mucosa. Transcriptome sequencing analysis of the colorectal mucosa allows the identification of potential neuropeptides related to local neurotransmission. The intestinal mucus lining the surface of the mucosa may harbor biomarkers of mucosal inflammation; however, this has not been sufficiently investigated, given the difficulty in obtaining human samples. We previously reported the feasibility of obtaining mucin samples for proteomic analysis by brushing during colonoscopy. Herein, we aimed to investigate the composition of the intestinal mucus and detect neuropeptides characteristic of UC.</p><p><strong>Methods: </strong>Mucus and mucosal samples were collected from patients with UC from the colorectum in areas showing remission or active UC using a brush catheter and biopsy forceps during colonoscopy. RNA sequencing findings of mucus samples of active and remission areas were compared. RNA and protein expression levels of significantly upregulated neuropeptides were analyzed.</p><p><strong>Results: </strong>Of the neuropeptides associated with UC, somatostatin (SST) was significantly elevated in areas of remission, according to RNA sequencing results of mucus and expression levels in mucus RNA and proteins. Conversely, SST expression in the mucosa was increased in the inflamed areas. Flow cytometry revealed that the fluorescence intensity of SST-positive cells in the remission zone was higher in the mucus than in the mucosa.</p><p><strong>Conclusion: </strong>SST expression in the mucus is considered to be an important factor associated with UC activity.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"400-410"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733790","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}
引用次数: 0
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