Digestive Diseases and Sciences最新文献_第4页

Does Short Myotomy Really Not Reduce the Risk of Reflux Esophagitis and Pathologic Acid Exposure After Peroral Endoscopic Myotomy?

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-20 DOI: 10.1007/s10620-025-08995-z

Jiali Wang, Han Zhang

引用次数: 0

Insights on Advanced Age as a Predictor of TIPS Outcomes in Elderly Patients.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-20 DOI: 10.1007/s10620-025-08991-3

Rusong Li, Chengfei Du

引用次数: 0

Older Adults with Inflammatory Bowel Disease Epidemiology in the United States: 2000-2021.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08976-2

Pojsakorn Danpanichkul, Yanfang Pang, Chawinthorn Vuthithammee, Disatorn Dejvajara, Priyata Dutta, Passisd Laoveeravat, Omar Al Ta'ani, Agnes Hy Ho, Chun Wei Pan, Nicole Shu Ying Tang, Kanokphong Suparan, Rashid N Lui, Donghee Kim, Siew C Ng, Gursimran Singh Kochhar, Francis A Farraye, Karn Wijarnpreecha

{"title":"Older Adults with Inflammatory Bowel Disease Epidemiology in the United States: 2000-2021.","authors":"Pojsakorn Danpanichkul, Yanfang Pang, Chawinthorn Vuthithammee, Disatorn Dejvajara, Priyata Dutta, Passisd Laoveeravat, Omar Al Ta'ani, Agnes Hy Ho, Chun Wei Pan, Nicole Shu Ying Tang, Kanokphong Suparan, Rashid N Lui, Donghee Kim, Siew C Ng, Gursimran Singh Kochhar, Francis A Farraye, Karn Wijarnpreecha","doi":"10.1007/s10620-025-08976-2","DOIUrl":"https://doi.org/10.1007/s10620-025-08976-2","url":null,"abstract":"Background: As the United States population ages, the incidence and prevalence of inflammatory bowel disease (IBD) among older adults are on the rise.Aims: This study provides updated estimates of the IBD burden in older adults and examines changes from 2000 to 2021.Methods: We analyzed data on IBD incidence, prevalence, and disability-adjusted life years (DALYs) in older adults (> 70 years) in the United States from the Global Burden of Disease Study 2021, stratified by sex and state. Using the Joinpoint regression model, we evaluated age-standardized rate changes from 2000 to 2021.Results: The study estimated 11,250 new cases, 180,880 prevalent cases, and 80,410 DALYs from IBD in older adults in the United States in 2021. In 2021, older adults-onset represented 15% of the total IBD population in the United States, a 3% increase since 2000. Between 2000 and 2021, the incidence (Annual percent change [APC]: 0.58%, 95%CI 0.50 to 0.66%) and DALYs rates (APC: 0.34%, 95%CI 0.07 to 0.62%) increased, while the prevalence rates remained stable. Incidence rate increased at a higher extent in older adults-onset IBD in females compared to that of males. Forty-seven states experienced increased older adults-onset IBD incidence rates during this period.Conclusion: From 2000 to 2021, the incidence and disability rates of older adults-onset IBD increased in the United States. Although older males initially had higher incidence rates, the rates have disproportionately increased among older females. The proportion of older adults-onset IBD cases and related disability has also grown, highlighting the urgent need for strategies to address the rising IBD burden in older adults.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662756","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

A Rare Cause of Small Bowel Obstruction with "Targets, Combs and Rash": Isolated Lupus Enteritis with Erythema Annulare Centrifugum.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08981-5

Jahnvi Dhar, Pankaj Gupta, Saroj Kant Sinha, Jayanta Samanta

引用次数: 0

A Survey on Endoscopy-Related Musculoskeletal Injuries in Japanese Endoscopists Focused on Injury Sites and Risk Factors.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08953-9

Shoko Ono, Sae Nakajima, Sae Owada, Natsumi Tomita, Momoko Tsuda, Michiko Yamada, Shinichi Katsuki, Naoya Sakamoto

{"title":"A Survey on Endoscopy-Related Musculoskeletal Injuries in Japanese Endoscopists Focused on Injury Sites and Risk Factors.","authors":"Shoko Ono, Sae Nakajima, Sae Owada, Natsumi Tomita, Momoko Tsuda, Michiko Yamada, Shinichi Katsuki, Naoya Sakamoto","doi":"10.1007/s10620-025-08953-9","DOIUrl":"https://doi.org/10.1007/s10620-025-08953-9","url":null,"abstract":"Purpose: Endoscopy examinations require complex and repetitive maneuvers that can put a strain on the musculoskeletal system, and there have been recent reports on endoscopy-related injuries (ERI). A survey was carried out with a focus on sites of injuries and risk factors for Japanese endoscopists.Methods: A 29-item web survey including non-identifiable demographic data, practice information, ERI, usability of endoscopes and ergonomics practice was carried out for Japanese endoscopists. ERI were defined as past or present endoscopy-related muscle and joint disorders including pain, discomfort, movement restriction, and numbness.Results: Data for 352 endoscopists were analyzed after excluding 49 endoscopists who had injuries not related to endoscopy. The incidences of ERI were 55.6% (150/270) in males and 61.0% (50/82) in females (not significant). The age of the endoscopists (≥ 36 years) and total number of endoscopy procedures per week (≥ 28) were found to be significant factors associated with ERI. Risk factors for hand injuries were total number of endoscopy procedures per week (≥ 28) and glove size (≥ size 7) for males and age (≥ 36 years) for females. The height (≥ 172 cm) was associated with neck injuries in male endoscopists. Also, number of ERCP procedures per week (≥ 1) in males and age (≥ 36 years) in females were risks for lower back injuries.Conclusion: ERI occurred at a high rate among Japanese endoscopists by a self-reporting survey. It is necessary to clarify the relationships between the site of injury and risk factors and take preventive measures.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656461","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

Persistence and Efficacy of Ustekinumab in Crohn's Disease After Anti-TNF Failure: An Observational Study.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08978-0

I Latras-Cortés, J C Sáez Hortelano, P Suárez-Álvarez, N Cano-Sanz, L Ortega-Valin, M Sierra-Ausín

{"title":"Persistence and Efficacy of Ustekinumab in Crohn's Disease After Anti-TNF Failure: An Observational Study.","authors":"I Latras-Cortés, J C Sáez Hortelano, P Suárez-Álvarez, N Cano-Sanz, L Ortega-Valin, M Sierra-Ausín","doi":"10.1007/s10620-025-08978-0","DOIUrl":"https://doi.org/10.1007/s10620-025-08978-0","url":null,"abstract":"Background: Anti-TNF treatment failure in Crohn's disease is common, and the literature on the selection of subsequent treatment is scant. Ustekinumab may be associated with high persistence rates and it appears to be effective in perianal disease.Aims: Primary objective: persistence, clinical, and biologic remission with ustekinumab.Secondary objectives: Persistence of the first biologic therapy, reasons for change of treatment, need for dose optimization, surgery, hospitalizations, and adverse events with ustekinumab.Methods: Retrospective, observational, single-center study from a prospective database of Crohn's disease adult patients receiving ustekinumab after failure of anti-TNF or vedolizumab. A sub-analysis was performed to evaluate ustekinumab persistence after the approval of risankizumab and upadacitinib.Results: Mean duration with ustekinumab was 27.65 months (SD 18.27) and persistence was 86.76%. Clinical remission was 40.63% at week 4, 54.35% at week 8, 54.9% at year 1, 76.92% at year 4, and 100% at year 5. Persistence with ustekinumab was longer than with anti-TNF: year 1, 93.2 vs 72.06%; year 2, 89.4 vs 45.59%; and year 3, 86.1 vs 30.88%. Just over one-third (36.76%) of patients required dose optimization. Nine (13.24%) patients stopped treatment due to primary non-response [1 (1.47%)], loss of response [5(7.35%)], and adverse events [3 (4.41%)]. Eleven (16.18%) patients needed surgery and hospitalization. After the approval of upadacitinib and risankizumab, ustekinumab persistence was 80.88%. Seven (70%) of the patients with perianal disease achieved clinical remission and 4 (40%) completed fistula healing.Conclusions: Ustekinumab may have better persistence as a second-line treatment compared to anti-TNF and may be effective in perianal disease.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662759","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

Impact of Antihypertensive and Lipid-Lowering Agents on Hepatocellular Carcinoma Risk in Patients with Fatty Liver Disease and Diabetes.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08935-x

Hyo Jung Cho, Eunyoung Lee, Soon Sun Kim, Jae Youn Cheong

{"title":"Impact of Antihypertensive and Lipid-Lowering Agents on Hepatocellular Carcinoma Risk in Patients with Fatty Liver Disease and Diabetes.","authors":"Hyo Jung Cho, Eunyoung Lee, Soon Sun Kim, Jae Youn Cheong","doi":"10.1007/s10620-025-08935-x","DOIUrl":"https://doi.org/10.1007/s10620-025-08935-x","url":null,"abstract":"Background/aim: This study aimed to evaluate the effects of antihypertensives, lipid-lowering agents, and antiplatelet medications on hepatocellular carcinoma (HCC) risk in patients with fatty liver disease (FLD) and type 2 diabetes (T2D).Method: Using data from Korea Health Insurance Review and Assessment Service, 212,443 FLD-T2D patients were analyzed through Cox regression, propensity score matching (PSM), and Kaplan-Meier analysis. The analysis considered medication use and its relation to HCC development. Cohort admission day was set as the date of the first oral hypoglycemic prescription.Results: The multivariate Cox regression analysis revealed that old age, male sex, chronic viral hepatitis, alcoholic liver disease, liver cirrhosis, using a combination of insulin and oral hypoglycemic agents for antidiabetic treatment, and calcium channel blocker (CCB) use were significantly correlated with higher HCC development risk, whereas dyslipidemia and statin, ezetimibe, and fibrate use was correlated with lower HCC risk, in the study cohort of 212,443 patients. Patients who used statins (hazard ratio [HR] = 0.58, 95% confidence interval [CI] = 0.42-0.80, P = 0.001) and fibrates (HR = 0.46, 95% CI = 0.22-0.93, P = 0.031) showed a significantly lower risk of HCC development even after PSM. In contrast, CCB use was linked to an elevated HCC risk (HR = 1.35, 95% CI = 1.05-1.72, P = 0.019), highlighting the differential impact of various medications on HCC incidence.Conclusion: The use of specific medications, such as statins and fibrates, may offer protective effects against HCC in patients with FLD-T2D, whereas that of CCB may increase the risk. This underscores the importance of tailored medication strategies for the management of chronic conditions.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662804","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

Impact of the Underutilization of Vibration-Controlled Transient Elastography in MASLD Patients Without Insurance Coverage.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08992-2

Christopher Ma, David S Goldberg

{"title":"Impact of the Underutilization of Vibration-Controlled Transient Elastography in MASLD Patients Without Insurance Coverage.","authors":"Christopher Ma, David S Goldberg","doi":"10.1007/s10620-025-08992-2","DOIUrl":"https://doi.org/10.1007/s10620-025-08992-2","url":null,"abstract":"Purpose: Vibration-controlled transient elastographies (VCTEs) are used to surveil disease progression in metabolic dysfunction-associated steatotic liver disease (MASLD), but this test is not covered by Florida Medicaid. This study aims to quantify the number of MASLD adults in a tertiary care center who did not obtain VCTEs despite indications for one based on their fibrosis-4 (FIB-4) scores, estimate the downstream costs associated with lack of VCTE access, and extrapolate these findings to the broader Florida Medicaid population.Methods: The study population was categorized into fibrosis risk groups based on their FIB-4 scores. For each insurance group (Medicaid, Medicare, and private), elastography studies and costs were collected and compared in patients who did or did not receive them. This data were then extrapolated to the statewide Medicaid MASLD population.Results: Among 282 MASLD patients with Medicaid, 64 patients were categorized as \"intermediate-risk\" for fibrosis based on their FIB-4, but only 4 had VCTEs performed. The number of VCTEs performed was significantly lower in the Medicaid group in comparison to all \"intermediate-risk\" patients with Medicaid, Medicare, and private insurance [χ2(2, N = 622) = 19.8, p < 0.001]. In the \"intermediate-risk\" Medicaid patients, the VCTE and non-VCTE groups averaged $86.74 ± 23.91 and $424.95 ± 63.49 per patient-year (p = 0.01), respectively, in elastography costs. When extrapolating these findings to the statewide Medicaid MASLD population, performing at least one VCTE could reduce downstream elastography costs by $136,020,921.51 ± 27,299,855.72 annually.Conclusion: VCTEs are underutilized in MASLD patients with Medicaid and VCTE use is associated with significantly lower downstream healthcare costs.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662753","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

A Soft Spot for Bleeding: Pseudoaneurysm of the Gastroduodenal Artery in a 71-Year-Old Woman Undergoing Electroporation for a Pancreatic Head Cancer.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-19 DOI: 10.1007/s10620-025-08985-1

Luca Properzi, Francesco Ricci, Massimiliano Allegritti, Jacopo Desiderio, Benedetta Enrico, Roberto Cirocchi, Giovanni Domenico Tebala

引用次数: 0

Racial Differences in Liver Fibrosis Burden.

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-18 DOI: 10.1007/s10620-025-08936-w

Michael L Attanasi, Mathew J Gregoski, Don C Rockey

{"title":"Racial Differences in Liver Fibrosis Burden.","authors":"Michael L Attanasi, Mathew J Gregoski, Don C Rockey","doi":"10.1007/s10620-025-08936-w","DOIUrl":"https://doi.org/10.1007/s10620-025-08936-w","url":null,"abstract":"Background & aims: Liver histology is the classic method for staging the severity of liver fibrosis, which in turn is an important predictor of clinical outcome. Here, we have hypothesized that the susceptibility to develop fibrosis varies among racial groups.Methods: We examined the histology of all patients over 18 years of age who underwent liver biopsy at the Medical University of South Carolina from 1/1/2013 to 7/1/2021. Patients with malignancy, liver metastases, or missing data were excluded. Fibrosis was quantified using the Batts-Ludwig system (F0 = no fibrosis to F4 = histological cirrhosis). Racial groups were propensity matched based on age, gender, diabetes, alcohol consumption, and CDC/ATSDR Social Vulnerability Index Themes to mitigate the risk of selection bias.Results: We identified 1101 patients with liver biopsy histological fibrosis scores. The cohort included 23% Black patients. After propensity matching, Black patients were significantly more likely to have Hepatitis C (73/228 (32%) vs 45/228 (20%), p < 0.001) and autoimmune hepatitis (34/228 (15%) vs 6/228 (3%), p < 0.001) than White patients, while White patients were significantly more likely to have metabolic dysfunction associated steatotic liver disease (71/228 (31%) vs 18/228 (8%), p < 0.001). White patients were significantly more likely to have cirrhosis than Black patients (White - 89/228 (39%) vs Black - 68/228 (30%), p < 0.05).Conclusion: White patients had a greater overall burden of advanced fibrosis (F4/cirrhosis) than Black patients, independent of etiology. The data suggest that fibrosis risk and/or progression may be worse in White than Black patients.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656482","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