Digestive Diseases and Sciences最新文献_第5页

SGLT2 Inhibitors in Cirrhosis: A Promising Therapeutic Avenue with Potential Risks. 肝硬化中的 SGLT2 抑制剂：具有潜在风险但前景广阔的治疗途径。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-24 DOI: 10.1007/s10620-024-08703-3

Alejandro J Loyola-Vélez, Binu V John

引用次数: 0

Disparities and Outcomes of Physical Restraint Use in Hepatic Encephalopathy: A National Inpatient Assessment. 肝性脑病患者使用物理约束的差异和结果：全国住院病人评估。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-24 DOI: 10.1007/s10620-024-08758-2

Yasmin O Ali, Spencer R Goble, Thomas M Leventhal

{"title":"Disparities and Outcomes of Physical Restraint Use in Hepatic Encephalopathy: A National Inpatient Assessment.","authors":"Yasmin O Ali, Spencer R Goble, Thomas M Leventhal","doi":"10.1007/s10620-024-08758-2","DOIUrl":"https://doi.org/10.1007/s10620-024-08758-2","url":null,"abstract":"Background: Physical restraints may be utilized in patients with hepatic encephalopathy with the intention to ensure patient safety.Aims: Determine if racial and socioeconomic disparities exist in restraint use for patients with hepatic encephalopathy and determine clinical efficacy of restraints in hepatic encephalopathy.Methods: We performed a cross-sectional retrospective study of hospitalizations for hepatic encephalopathy from 2016 to 2021 using the National Inpatient Sample. Patient race and income were assessed for associations with restraint use and restraints themselves were then assessed for associations with clinical outcomes including mortality. Separate analyses were performed for hospitalizations with and without invasive cares defined as the presence of ICD-10 codes for mechanical ventilation, gastric tube placement and/or central venous catheter placement.Results: Restraint use was documented in 2.4% of 228,430 hospitalizations. In hospitalizations without defined invasive cares, restraint use was increased in Black patients compared to White patients (aOR = 1.57, 95% CI 1.24-1.98, p < 0.001) while lower income was not independently associated with restraint use (1st vs. 4th quartile national income aOR = 0.98, p = 0.895). In hospitalizations that did not involve other defined invasive cares, physical restraint use was associated with higher mortality (aOR = 1.71, 95% CI 1.20-2.43, p = 0.003), whereas in hospitalizations where invasive cares were employed, physical restraint use was associated with reduced mortality (aOR = 0.55, 95% CI 0.40-0.77, p < 0.001).Conclusions: Careful consideration of the necessity of restraints in hepatic encephalopathy hospitalizations without other invasive cares appears warranted as social disparities in restraint use and increased mortality were both found in this group.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709339","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

Small Bowel Obstruction by Phytobezoar. 植物虫造成的小肠梗阻

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-22 DOI: 10.1007/s10620-024-08763-5

Chun-Lin Ying, Jian Zha, Wei Liu

引用次数: 0

Alcohol-Associated Hepatitis: Short- and Long-Term Management. 酒精相关肝炎：短期和长期管理。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-22 DOI: 10.1007/s10620-024-08705-1

Sergio A De La Torre, Marco Morcos, Sammy Saab, Akshay Shetty

引用次数: 0

Indications and Outcomes with Liver Retransplantation in 2025. 2025 年肝脏再移植的适应症和结果。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-22 DOI: 10.1007/s10620-024-08741-x

Alisa Likhitsup, Robert J Fontana

{"title":"Indications and Outcomes with Liver Retransplantation in 2025.","authors":"Alisa Likhitsup, Robert J Fontana","doi":"10.1007/s10620-024-08741-x","DOIUrl":"https://doi.org/10.1007/s10620-024-08741-x","url":null,"abstract":"Five to 10% of the annual liver transplants in the United States are performed in prior liver recipients with 70% occurring within 1 year of transplantation. Fortunately, the incidence of primary non-function (PNF) has significantly decreased from 8% in the 1980's to < 2%, but PNF and hepatic artery thromboses remain the leading reasons for early emergency retransplantation. Other indications for early retransplantation include severe biliary or vascular complications and refractory rejection. Fortunately, the need for late retransplantation (> 1 year) has also declined due to improved immunosuppression, earlier detection of recurrent disease, and use of oral antiviral agents for recurrent hepatitis C. Patient survival with retransplantation is consistently lower than with primary liver transplantation. Risk factors for poor outcomes with retransplantation include a higher MELD score, ICU status, renal failure, and use of marginal allografts. Therefore, most centers use younger, whole deceased brain-dead donor organs whenever possible. However, increased use of machine perfused livers has expanded the donor pool for these more complex and technically challenging cases. Retransplant recipients have a higher rate of early technical, infectious, and cardiovascular complications compared to primary LT recipients. Going forward, LT recipients with recurrent steatotic and alcoholic liver disease will likely pose ethical, medical, and surgical challenges to the transplant community.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686179","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

Transanastomotic Forward-Viewing EUS-Guided Pancreatic Duct Drainage via Afferent Loop for Pancreaticojejunostomy Anastomotic Stricture After Pancreaticoduodenectomy. 胰十二指肠切除术后经吻合口前向回视超声引导胰腺导管引流术治疗胰空肠吻合口狭窄。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-21 DOI: 10.1007/s10620-024-08743-9

Tadahisa Inoue, Rena Kitano, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito

{"title":"Transanastomotic Forward-Viewing EUS-Guided Pancreatic Duct Drainage via Afferent Loop for Pancreaticojejunostomy Anastomotic Stricture After Pancreaticoduodenectomy.","authors":"Tadahisa Inoue, Rena Kitano, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito","doi":"10.1007/s10620-024-08743-9","DOIUrl":"https://doi.org/10.1007/s10620-024-08743-9","url":null,"abstract":"Background: Although balloon enteroscopy-assisted ERCP and transgastric EUS-guided pancreatic duct drainage (EUS-PD) are treatment option for pancreaticojejunostomy anastomotic stricture (PJAS), they are often challenging with several limitations. This study aimed to examine the feasibility of transanastomotic forward-viewing EUS-PD (FVEUS-PD) via the afferent loop for PJAS after pancreaticoduodenectomy.Methods: Ten consecutive patients with symptomatic PJAS who underwent FVEUS-PD between 2015 and 2021 were retrospectively evaluated. Study outcomes included technical and clinical success, adverse events, and recurrence rates associated with FVEUS-PD. A short dumbbell-shaped, fully covered metal stent was deployed in all cases, and the stent was removed 3 month after placement, after which it became stent-free.Results: The technical success rate was 80% (8/10), and the scope could not reach the PJAS in two patients. Clinical success was achieved in all technically successful patients. No procedure-related adverse events observed. All patients were followed up for over three years after metal stent removal and becoming stent-free; the median follow-up period was 63 month. One patient developed symptomatic stricture recurrence 36 month after removal, with a stricture recurrence rate of 13% (1/8). The remaining patients did not experience any recurrence or late adverse events during the study period.Conclusions: This study is the first to investigate FVEUS-PD, demonstrating promising technical feasibility with low adverse event and recurrence rates, potentially becoming a useful treatment option for PJAS.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681242","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

Love Thy Neighbor? Exploring Gastroenterology Attitudes Toward Endometriosis Screening. 爱你的邻居？探讨消化内科对子宫内膜异位症筛查的态度。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-21 DOI: 10.1007/s10620-024-08740-y

Yuying Luo, Xiao Jing Wang, Laurie A Keefer, Madison Simons

引用次数: 0

Incidental Subvesical Bile Duct in a Patient with Mirizzi Syndrome. 一名米利兹综合征患者偶然发现的腹腔下胆管

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-21 DOI: 10.1007/s10620-024-08744-8

Ping-Hung Ko, Chih -Wei Tseng

引用次数: 0

Disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease Prevalence, Diagnosis, Treatment, and Outcomes: A Narrative Review. 代谢功能障碍相关性脂肪肝发病率、诊断、治疗和结果的差异：叙述性综述。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-19 DOI: 10.1007/s10620-024-08722-0

Kaia C Miller, Bridget Geyer, Anastasia-Stefania Alexopoulos, Cynthia A Moylan, Neha Pagidipati

{"title":"Disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease Prevalence, Diagnosis, Treatment, and Outcomes: A Narrative Review.","authors":"Kaia C Miller, Bridget Geyer, Anastasia-Stefania Alexopoulos, Cynthia A Moylan, Neha Pagidipati","doi":"10.1007/s10620-024-08722-0","DOIUrl":"10.1007/s10620-024-08722-0","url":null,"abstract":"Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a leading cause of morbidity and mortality, and health disparities have been shown to influence disease burden.Aim: In this review, we aim to characterize disparities in prevalence, diagnosis, treatment, and outcomes of MASLD, and to make recommendations for next steps to minimize these disparities.Methods: Literature search on PubMed and Scopus databases was conducted to identify relevant articles published before September 2, 2024.Results: Relative to women and White populations, MASLD is more common in men and Hispanic populations and less common in Black populations. It is also more prevalent among those with lower SES. Noninvasive clinical scores may perform differently across groups, and screening practices vary both for initial disease and for progression to metabolic dysfunctionassociated steatohepatitis (MASH), formerly called non-alcoholic steatohepatitis (NASH). Women and Black and Hispanic patients suffer worse outcomes including rates of progression to MASH and mortality.Conclusions: Health disparities related to race, ethnicity, gender, and socioeconomic factors impact multiple stages of care for patients with MASLD.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667420","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

FIT as a Comparator for Evaluating the Effectiveness of New Non-invasive CRC Screening Test. 将 FIT 作为评估新型无创 CRC 筛查试验有效性的对比试验。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2024-11-19 DOI: 10.1007/s10620-024-08718-w

Carlo Senore, Chyke Doubeni, Lydia Guittet

{"title":"FIT as a Comparator for Evaluating the Effectiveness of New Non-invasive CRC Screening Test.","authors":"Carlo Senore, Chyke Doubeni, Lydia Guittet","doi":"10.1007/s10620-024-08718-w","DOIUrl":"10.1007/s10620-024-08718-w","url":null,"abstract":"Randomized Controlled Trials (RCT) demonstrated that guaiac-based fecal occult blood test (gFOBT), sigmoidoscopy, or colonoscopy are effective at reducing colorectal cancer (CRC) risk and mortality. Even if the impact of fecal immunochemical test (FIT) has not been evaluated within population-based RCT with mortality as the outcome, the results of comparative analyses with gFOBT provide strong indirect evidence of its effectiveness. Extensive information is also available on sensitivity and specificity of FIT, compared with gFOBT. FIT has almost universally replaced gFOBT in organized screening programs worldwide. Using FIT as a comparator is an efficient way to evaluate the effectiveness of new tests, with respect to test performance and relevant intermediate outcomes such as rates of interval cancer and late-stage cancer incidence. Direct comparison with FIT in the pre-screening evaluation of the accuracy of the new test will guide selection of the cut-off of the new test, and document the potential gain in sensitivity. Comparison in cross-sectional single-round screening evaluation can either use paired or parallel designs. Only parallel designs allow direct comparisons of participation rates. Relative accuracy can be derived in both designs with an assumption of similar colorectal cancer and precursor prevalence between groups in parallel designs. Finally, multiple-rounds prospective comparison will document potential effect on risk of CRC and precancerous lesions, and on absolute reductions in late-stage incidence as a proxy of mortality. This paper provides an overview of evidence and rationale for using FIT as a comparator for evaluating new non-invasive tests with repeated testing at short intervals.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666334","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