Digestive Diseases and Sciences最新文献

{"title":"Outcomes of Acute Pancreatitis Hospitalizations with Obesity.","authors":"Neelam Khetpal, Mohamad Sharbatji, Mohammad Maysara Asfari, Sarfraz Ahmad","doi":"10.1007/s10620-025-08880-9","DOIUrl":"10.1007/s10620-025-08880-9","url":null,"abstract":"<p><strong>Objective: </strong>Assessing the relationship of body mass index (BMI) on acute pancreatitis (AP) hospitalization in the United States (US).</p><p><strong>Methods: </strong>The National Inpatient Sample utilized to capture normal weight, overweight, and obese AP hospitalization in the US during 2020 based on BMI. Patients, hospitalization characteristics, and outcomes were compared.</p><p><strong>Results: </strong>In 2020, there were 53,000 (20%) obese, 3980 (2.6%) overweight, and 210,000 (77.4%) normal weight AP hospitalizations. All-cause inpatient mortality was similar for obese, and overweight compared to normal weight AP hospitalizations, respectively (0.65% vs 0.63% vs 0.6%). Furthermore, obese AP hospitalization had a higher chance of developing systemic [odds ratio (OR): 1.7, confidence interval (CI) (1.35-2.12)], and needing intubation or vasopressor requirement OR: 1.75, CI (1.14-2.68), compared to normal AP patients. However, overweight AP hospitalizations had similar chance of developing systemic OR: 1.1, CI (0.83-1.38) and local complication OR: 1.14, CI (0.88-1.5), needing intubation or vasopressor requirements OR: 1.27, CI (0.73-2.23) except use of jejunostomy tube was higher OR: 1.74, CI (1.1-2.75) compared to normal weight AP hospitalizations. The mean length-of-stay and mean total healthcare costs were higher among obese by 2.14 days (CI 0.9-3.37), p = 0.001 and by US$ 21,626, CI (4379-38,872), p = 0.014 compared to normal weight AP hospitalizations.</p><p><strong>Conclusions: </strong>Obese and overnight AP hospitalizations had similar inpatient mortality compared to normal weight hospitalizations. Obese AP hospitalizations have higher complications and healthcare utilization compared to normal weight hospitalizations.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1350-1359"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Great Weight, Low Pressure-One Problem: GLP-1 Receptor Agonist-Associated Colonic Ischemia.","authors":"Hannah Ramrakhiani, Andrew K Roorda, Thu Tran, Katerina Shetler, George Triadafilopoulos","doi":"10.1007/s10620-025-08984-2","DOIUrl":"10.1007/s10620-025-08984-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1316-1319"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Biopsy - An Essential LiFT in the Diagnosis of Unexplained Liver Disease.","authors":"Don C Rockey","doi":"10.1007/s10620-025-08900-8","DOIUrl":"10.1007/s10620-025-08900-8","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1274-1276"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Case of Gastric Mucosal Erosions.","authors":"Yingxin Chen, Kun Ma, Yange Zhao, Tianyuan Yuan, Shaoxuan Wang","doi":"10.1007/s10620-025-08894-3","DOIUrl":"10.1007/s10620-025-08894-3","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1255-1256"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IBS and IBD-One Letter, Much Pain, Few Treatments.","authors":"Jaime E Scott, Sasha Taleban","doi":"10.1007/s10620-025-08892-5","DOIUrl":"10.1007/s10620-025-08892-5","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1277-1279"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-tumor Necrosis Factor Drug Concentration Is Not Associated with Disease Outcomes in Pouchitis: A Retrospective, International Study.","authors":"Sailish Honap, Bénédicte Caron, Jacob E Ollech, Maya Fischman, Konstantinos Papamichael, Djuna De Jong, Krisztina B Gecse, Andrea Centritto, Mark A Samaan, Peter M Irving, Miles P Sparrow, Konstantinos Karmiris, Thomas Chateau, Iris Dotan, Laurent Peyrin-Biroulet","doi":"10.1007/s10620-024-08821-y","DOIUrl":"10.1007/s10620-024-08821-y","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic drug monitoring is important for optimizing anti-tumor necrosis factor-α (TNF-α) therapy in inflammatory bowel disease. However, the exposure-response relationship has never been assessed in pouchitis.</p><p><strong>Aims: </strong>To explore associations between anti-TNF-α drug concentration and pouchitis disease activity in patients with a background of ulcerative colitis.</p><p><strong>Methods: </strong>A retrospective, multicenter, cross-sectional study was conducted in adult patients with pouchitis requiring anti-TNF-α treatment. Rates of clinical and endoscopic remission were calculated, and drug concentrations during maintenance therapy were compared between remission and non-remission cohorts.</p><p><strong>Results: </strong>Sixty-three patients were included: median age, 48 years (IQR 36-59) and median time since pouchitis diagnosis, 7 years (IQR 2-13). Patients received infliximab, n = 27 (43%), adalimumab, n = 29 (46%), or both n = 7 (11%). Thirty-two (51%) patients received concomitant immunomodulation. Median infliximab trough concentrations (mg/ml) were similar between patients in clinical remission (n = 21) vs non-remission (n = 11), 5.3 vs. 4.4, p = 0.73. For adalimumab, median drug concentrations did not significantly differ between remission/non-remission groups based on clinical (n = 18/18), 11.4 vs 7.6, p = 0.32, or endoscopic assessment, (n = 7/29), 9.0 vs. 7.8, p = 0.78. Four patients had positive anti-drug antibodies with undetectable drug concentration.</p><p><strong>Conclusion: </strong>In a cohort of patients with pouchitis, higher anti-TNF-α drug concentrations were not associated with more clinical or endoscopic remission.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1320-1327"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Liver Fibrosis Impairs Cardiorespiratory Fitness in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Miguel Sogbe, Breianna Hummer, Jonathan G Stine, Blanca Lizaola-Mayo, Daniel E Forman, Hugo E Vargas, Andres Duarte-Rojo","doi":"10.1007/s10620-025-08893-4","DOIUrl":"10.1007/s10620-025-08893-4","url":null,"abstract":"<p><strong>Background: </strong>MASLD is a leading reason for liver transplant waitlisting. The relationship between cardiorespiratory fitness (CRF) and liver fibrosis in patients with MASLD remains unclear. This study aims to provide further evidence supporting the relationship between liver fibrosis and CRF.</p><p><strong>Methods: </strong>Participants with MASLD across various fibrosis stages, including those with cirrhosis awaiting liver transplantation from three U.S. transplant centers, underwent cardiopulmonary exercise testing (CPX). We compared participants based on fibrosis stage (F0-F1, F2-F3, and F4) and CPX parameters such as VO_2peak, respiratory exchange ratio (RER), ventilatory efficiency (VE/VCO₂), double product (DP) and chronotropic incompetence (CI). Multivariable models were then built to evaluate factors associated with these parameters.</p><p><strong>Results: </strong>Sixty-one participants underwent CPX testing across three centers. Participants with F4 had lower VO_2peak (11.8 mL/kg/min) compared to F0-F1 (22.2 mL/kg/min) and F2-F3 (22.9 mL/kg/min), p < 0.001. Participants with F4 had higher RER (median 1.25) compared to F0-F1 (1.08) and F2-F3 (1.05), p = 0.001. Similarly, F4 participants exhibited higher VE/VCO₂ (median 36.5) compared to F0-F1 (31) and F2-F3 (30), p < 0.001. Additionally, F4 participants had lower DP values (median 17,696) compared to F0-F1 (25,460) and F2-F3 (25,372), and higher prevalence of CI (90%) compared to F0-F1 (39%) and F2-F3 (25%), both p =  < 0.001. Multivariable modeling confirmed advanced fibrosis (F > 3) as an independent predictor of low CRF.</p><p><strong>Conclusions: </strong>In MASLD patients, advanced liver fibrosis, particularly cirrhosis, is associated with reduced CRF and poorer hemodynamic performance during CPX. Prioritizing exercise training for those in earlier stages (F3) may prevent fitness decline, which could hinder physical training and liver transplantation candidacy.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1530-1539"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Cholecystectomy on Bubble Formation and Endoscopic Visualization: A Retrospective Cohort Study.","authors":"Jeffrey Loeffler, Gaetano Di Pietro, Hamed Chehab, Mira AlSheikh, Harika Kandlakunta, Hassan Al Moussawi, Danial Daneshvar, Yosef Buchen, Dineshreddy Gurala, Shivantha Amarnath, Mohammad Abureesh, Ahmed Elfiky, Vivek Gumaste, Sherif Andrawes","doi":"10.1007/s10620-025-08911-5","DOIUrl":"10.1007/s10620-025-08911-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the association between cholecystectomy and colonic bubble formation during colonoscopy, METHODS: A single-center retrospective cohort study was conducted at Staten Island University Hospital. Researchers reviewed 348 colonoscopy reports, comparing patients with (n = 56) and without (n = 292) a history of cholecystectomy. Colonic bubble formation was assessed using a 0-3 scale (0 = no bubbles, 3 = severe bubbles). Secondary endpoints included polyp and adenoma detection, withdrawal and procedure times, bowel preparation quality, and repeat procedures. Statistical analysis included t-tests, Mann-Whitney U tests, and χ² tests.</p><p><strong>Results: </strong>Patients with prior cholecystectomy had significantly higher incidence of severe bubble formation (score 3; 28.6% vs. 12%, p = 0.001), longer withdrawal times (18 ± 8 vs. 15 ± 5 min, p = 0.024), and increased need for repeat colonoscopies (10.7% vs. 2.1%, p = 0.001). No significant differences were found in adenoma detection, polyp detection, or bowel preparation quality between the two groups.</p><p><strong>Conclusion: </strong>Cholecystectomy is associated with increased colonic bubble formation during colonoscopy, leading to longer withdrawal times and higher rates of repeat procedures. While this study did not find a difference in adenoma detection rates, the impaired visualization caused by bubbles may necessitate tailored bowel preparation strategies for patients with a history of cholecystectomy to optimize colonoscopy effectiveness.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1555-1559"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Renal Replacement Therapy Requirement in Cirrhotic Patients with Acute Kidney Injury.","authors":"Jeffrey Loeffler, Mohammed Hassan, Faris Qaqish, Reem Dimachkie, Shabnam Dehghani, Roula Sasso, Ahmad Abou Yassine, Liliane Deeb","doi":"10.1007/s10620-025-08881-8","DOIUrl":"10.1007/s10620-025-08881-8","url":null,"abstract":"<p><strong>Background: </strong>Renal failure is a well-known and often devastating complication in patients with liver cirrhosis and contributes to significant morbidity and mortality.</p><p><strong>Aims: </strong>This study aimed to evaluate the clinical profile and factors associated with the utilization of renal replacement therapy (RRT) requirement in cirrhotic patients presenting with AKI.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of cirrhotic inpatient visits across all Northwell Health hospitals between January 1, 2019 and December 31, 2020. Patients meeting inclusion criteria were identified using the International Classification of Disease, tenth revision clinical modification (ICD-10-CM) codes. Clinical variables, including demographics, medical history, laboratory data, and outcomes, were collected. Statistical analyses were performed to compare variables between patients requiring RRT and those not requiring RRT.</p><p><strong>Results: </strong>Of 701 cirrhotic patient encounters, 516 met inclusion criteria. The most common etiology of AKI was pre-renal (45.3%), followed by hepatorenal syndrome (18.6%) and acute tubular necrosis (14.7%). Sixty patients (11.6%) required RRT, with worse outcomes observed in this group. Independent predictors of RRT requirement included hepatorenal syndrome, acute tubular necrosis, and pneumonia. Pre-renal AKI was associated with decreased likelihood of requiring RRT.</p><p><strong>Conclusion: </strong>This study identified clinical and laboratory factors predicting RRT requirement in cirrhotic patients with AKI. Hepatorenal syndrome, acute tubular necrosis, and pneumonia were associated with increased likelihood of RRT. Understanding these predictors may aid in prognostication and management decisions for cirrhotic patients presenting with AKI, warranting further prospective validation studies.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1540-1546"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projected Mitigation of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B in the Gray Zone and the Immune-Tolerant Phase in the United States.","authors":"Kevin Pak, Ryan Sachar, Sammy Saab","doi":"10.1007/s10620-025-08909-z","DOIUrl":"10.1007/s10620-025-08909-z","url":null,"abstract":"<p><strong>Purpose: </strong>Based on current practice guidelines, there are a substantial number of individuals who do not meet criteria for chronic hepatitis B (CHB) treatment eligibility but may be at risk of developing HCC. We sought to determine the estimated number of untreated patients with CHB in the Gray Zone or immune-tolerant phase who would develop HCC.</p><p><strong>Methods: </strong>US epidemiologic data were obtained from the US Department of HHS. The literature was reviewed for studies that analyzed the distribution of phases of CHB patients including the Gray Zone and studies that determined the cumulative incidence of HCC over a set period unique to both the Gray Zone and the immune-tolerant phase populations. We modeled the projected number of patients in each group who would develop HCC in a period of 5 and 10 years.</p><p><strong>Results: </strong>There are about 880,000 to 1.89 million people living with CHB in the US. Based on our model, we estimated 1224-4146 patients and 6662-22,574 patients will likely develop HCC in 5 years and 10 years, respectively, if left untreated in the high viral load and normal liver enzyme Gray Zone. An estimated 356-1537 patients and 873-3774 patients will develop HCC in 5 years and 10 years, respectively, if left untreated in the immune-tolerant phase of CHB. Among patients who develop cirrhosis in the Gray Zone, approximately, 1615-5471 patients will develop HCC.</p><p><strong>Conclusion: </strong>Current guidelines do not recommend hepatitis B antiviral therapy in patients in the Gray Zone and the immune-tolerant phase. Patients who fall into these categories are still at risk for HCC. By the numbers, the projected number of patients to develop HCC among these populations is in the order of thousands. Future guidelines should explore increasing treatment eligibility for potential mitigation of HCC burden in the US.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"1547-1554"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467316","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}