Digestive Diseases and Sciences最新文献

{"title":"Association Between Glycemic Variability and All-Cause Mortality in Patients with Acute Pancreatitis in the Intensive Care Unit: A Retrospective Analysis.","authors":"Lianjie Lin, Zhihai Liang","doi":"10.1007/s10620-025-09012-z","DOIUrl":"https://doi.org/10.1007/s10620-025-09012-z","url":null,"abstract":"<p><strong>Background: </strong>Identifying high-risk acute pancreatitis (AP) patients in the ICU is vital for improving prognosis. Thus, this study aims to explore the relationship between the coefficient of variation (CV) of blood glucose and the all-cause mortality of patients with AP in the ICU.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on AP patients in the MIMIC-IV database. The CV was used to describe the glycemic variability (GV) and the optimal cut-off value was determined using the ROC curve. Subsequently, analyze the correlation between CV and all-cause mortality.</p><p><strong>Results: </strong>A total of 907 patients with AP in the ICU were included in this study. The ROC curve determined the optimal CV cut-off value as 0.25. The KM survival curves and univariate and multivariate logistics regression analyses all showed that CV was associated with the 30-day, 60-day, and 90-day all-cause mortality (P < 0.05). The RCS curves showed a nonlinear correlation (P < 0.05). When CV is less than 0.421, 0.449, and 0.428, respectively, the risk of death at 30-day, 60-day, and 90-day increases as the CV value rises. Subgroup analysis showed an interaction between congestive heart failure and CV in 30-day and 60-day all-cause mortality, between age and CV in 60-day and 90-day all-cause mortality, and between chronic pulmonary disease and CV in 30-day all-cause mortality (P all < 0.05).</p><p><strong>Conclusion: </strong>The CV is associated with the all-cause mortality of AP patients in the ICU, especially when the CV value is between 0.25 and 0.45. When using CV, the effects of age, congestive heart failure, and chronic pulmonary disease should be considered.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751437","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":"Risk Factors for Glue Extrusion Bleeding After Endoscopic Injection of Cyanoacrylate Glue for Gastric Varices: A Retrospective Study of 269 Patients.","authors":"Yihuan Hu, Mei Zhou, Deliang Liu, Jian Gong","doi":"10.1007/s10620-025-08999-9","DOIUrl":"https://doi.org/10.1007/s10620-025-08999-9","url":null,"abstract":"<p><strong>Background: </strong>Glue extrusion bleeding is a major complication of endoscopic cyanoacrylate glue injection for the treatment of gastric varices. However, its risk factors remain unclear.</p><p><strong>Aims: </strong>This retrospective study aimed to evaluate the risk factors for bleeding associated with glue extrusion.</p><p><strong>Methods: </strong>This study analyzed the medical data of cirrhotic patients who underwent endoscopic obliteration for gastric varices using cyanoacrylate glue between January 2016 and December 2022. The data within 1 year after therapy were carried out with logistic regression. A nomogram model was constructed based on the factors.</p><p><strong>Results: </strong>269 patients were enrolled. Risk factors associated with glue extrusion bleeding included the volume of the glue (≥ 4 mL)(OR 1.289, 95% CI 1.051-1.580; P = 0.015), massive ascites (OR 5.645, 95% CI 2.260-14.097; P = 0.000), active hemorrhage during endoscopy (OR 2.830, 95% CI 1.284-6.234; P = 0.010), and the use of β-blockers was a protective factor (OR 0.185, 95% CI 0.07-0.485; P = 0.001). The nomogram model had good prediction accuracy, with an area under the curve of 0.74 (95% CI 0.658-0.822; P < 0.001).</p><p><strong>Conclusion: </strong>Massive ascites, active hemorrhage during endoscopy, glue volume ≥ 4 mL, and the use of β-blockers are associated with glue extrusion bleeding. At-risk patients may benefit from controlling the volume of the glue, undergoing endoscopic ultrasound and using β-blockers.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751443","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":"Engineered Probiotic Saccharomyces boulardii Reduces Colitis-Associated Colorectal Cancer Burden in Mice.","authors":"Tyler Culpepper, Krithika Senthil, Jessica Vlcek, Anthony Hazelton, Mairead K Heavey, Rani S Sellers, Juliane Nguyen, Janelle C Arthur","doi":"10.1007/s10620-025-09008-9","DOIUrl":"10.1007/s10620-025-09008-9","url":null,"abstract":"<p><strong>Background: </strong>Individuals with inflammatory bowel diseases experience an elevated risk of colorectal cancer driven by chronic inflammation. Current systemic immunosuppressive therapies often cause severe side effects. Live oral biotherapeutics are an emerging treatment modality that directly target the intestines. We have engineered a probiotic Saccharomyces boulardii strain that expresses targeting ligands to bind fibronectin on inflamed mucosa and secretes anti-tumor necrosis factor nanobodies locally to reduce inflammation. We previously demonstrated that engineering S. boulardii to bind fibronectin enhanced colonization and reduced inflammation in a DSS colitis model.</p><p><strong>Aims: </strong>Here, we tested the anti-cancer potential of engineered S. boulardii using a well-established model of IBD-associated CRC, azoxymethane-treated interleukin 10-deficient (AOM/Il10^-/-) mice. These mice develop inflammation and invasive tumors that model those found in inflammatory bowel disease.</p><p><strong>Methods: </strong>Mice were orally administered engineered S. boulardii at two dosing frequencies, unmodified S. boulardii, or placebo throughout the 18-week model. Colons were harvested for gross, histological, and molecular evaluation for inflammation and tumorigenesis.</p><p><strong>Results: </strong>Histological colon inflammation was reduced by twice weekly dosing of engineered and unmodified S. boulardii. Engineered S. boulardii reduced gross tumor number in a dose-dependent manner, with median tumor counts reduced from 7.5 to 2 per mouse (p < 0.0002 vs. placebo). Unmodified S. boulardii similarly reduced gross tumor number. Colonization studies revealed that engineered S. boulardii failed to colonize for greater time or density vs. unmodified S. boulardii.</p><p><strong>Conclusion: </strong>Together our data indicate that engineering S. boulardii does not reduce its ability to decrease inflammation-associated tumorigenesis, and that further host-binding target optimization is required to enhance colonization and anti-cancer effects.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742644","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":"Risk of Advanced Adenomas in Siblings Aged ≤ 50 Years of Patients with Early-Onset Colorectal Advanced Adenomas.","authors":"Luan Minh Dang, Nhan Quang Le, Huy Minh Le, Diem Thi-Ngoc Vo, Nguyen Lam Vuong, Minh Cuong Duong, Duc Trong Quach","doi":"10.1007/s10620-025-09014-x","DOIUrl":"https://doi.org/10.1007/s10620-025-09014-x","url":null,"abstract":"<p><strong>Purpose: </strong>The risk of colorectal advanced adenomas (CAAs) and colorectal cancer (CRC) in siblings aged ≤ 50 of patients diagnosed with early-onset CAAs (E-CAAs), defined as having CAA at or below 50 years, is poorly understood. This study examined the risks of adenomas, CAA, and CRC in siblings aged ≤ 50 of patients diagnosed with E-CAA.</p><p><strong>Methods: </strong>This case-control study was conducted at a tertiary hospital in Vietnam. The participants included 96 cases who were siblings aged ≤ 50 of patients diagnosed with E-CAA. Controls were randomly selected from consecutive patients aged ≤ 50 who did not have siblings diagnosed with E-CAA. Controls were matched to cases in a 2:1 ratio for age, sex, and smoking status.</p><p><strong>Results: </strong>The mean age was similar between cases (40.9 ± 6.0 years) and controls (41.1 ± 6.0 years). Except for indications for colonoscopy, there were no significant differences in the baseline demographics between the two groups. A heightened risk of CAA was documented in cases compared with controls (odds ratio [OR] 6.33; 95% confidence interval [CI] 1.43-43.8; P = 0.018). This increased risk was more pronounced in males (OR 13.7; 95% CI 1.23-262; P = 0.006). Cases had higher risks of colorectal adenomas (OR 2.43; 95% CI 1.27-4.67; P = 0.009) and colorectal neoplasia (OR 2.33; 95% CI 1.24-4.40; P = 0.011) than those in controls.</p><p><strong>Conclusion: </strong>Siblings aged ≤ 50 of patients diagnosed with E-CAA have an increased risk of adenomas, CAA, and colorectal neoplasia. CRC screening should be initiated early in these high-risk individuals.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742645","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":"Severe Hyperhomocysteinemia, an Unusual Case of Liver Cirrhosis.","authors":"TianSong Fan, XiaoYun Zhu, Xiao Ma, Bo Yin, PeiDong Wang","doi":"10.1007/s10620-025-09006-x","DOIUrl":"https://doi.org/10.1007/s10620-025-09006-x","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735747","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":"Author Spotlight: Dr. Catalina Mulanax, MD.","authors":"Catalina Mulanax","doi":"10.1007/s10620-025-08994-0","DOIUrl":"https://doi.org/10.1007/s10620-025-08994-0","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735793","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":"Differential Prognostic Impact of Tumor Burden Score on Hepatocellular Carcinoma Patients with Variable Physical Performance Status.","authors":"Hung-Ting Tseng, Po-Hong Liu, Chia-Yang Hsu, Yi-Hsiang Huang, Chien-Wei Su, Ming-Chih Hou, Shu-Yein Ho, Teh-Ia Huo","doi":"10.1007/s10620-025-08971-7","DOIUrl":"https://doi.org/10.1007/s10620-025-08971-7","url":null,"abstract":"<p><strong>Background: </strong>Performance status (PS) plays a crucial role in prognostic prediction for patients with hepatocellular carcinoma (HCC). The extent of tumor burden is also a major survival determinant. Recently, tumor burden score (TBS) was proposed to evaluate the extent of tumor involvement, but the interaction between TBS and PS has not been evaluated. We aimed to assess the prognostic role of TBS in HCC patients with variable PS.</p><p><strong>Methods: </strong>A large cohort of 4185 treatment-naïve HCC patients were retrospectively analyzed. The multivariate Cox proportional hazards model was used to determine the independent predictors associated with survival.</p><p><strong>Results: </strong>Patients with poorer PS had significantly higher TBS at baseline. In the Cox model, older age, lower serum albumin level, higher serum bilirubin, creatinine and α-fetoprotein levels, presence of ascites, presence of vascular invasion, PS 1-2, PS 3-4, and medium TBS and high TBS were independently associated with increased mortality in the entire cohort (p < 0.001). In subgroup analysis stratified by PS, TBS was able to predict long-term survival in patients with PS 0 in the multivariate model. For patients with PS 1-2, the trend was significant only in those with high TBS (p < 0.001); in patients with PS 3-4, TBS was not significantly associated with survival (p > 0.05).</p><p><strong>Conclusions: </strong>TBS is a feasible prognostic surrogate for HCC and can well discriminate long-term survival in patients with good PS. Our findings demonstrate that TBS has a differential prognostic impact on HCC and may play a distinct role in outcome prediction for patients with variable PS.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735716","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":"Numbers Matter: Influence of Pancreatitis on Life Expectancy.","authors":"Simon Sirtl, Mahmood Ahmad, Max Ole Hubert, Julia Mayerle","doi":"10.1007/s10620-025-09013-y","DOIUrl":"https://doi.org/10.1007/s10620-025-09013-y","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735795","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":"EUS-FNA Diagnosis of Pancreatic Undifferentiated Sarcoma.","authors":"Ruixiang Xue, Xinyu Lu, Linheng Wang, Yuyue Liu, Dan Peng, Na Yao, Pei Deng","doi":"10.1007/s10620-025-08987-z","DOIUrl":"https://doi.org/10.1007/s10620-025-08987-z","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718373","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":"The Global, Regional, and National Burden of Pancreatitis in 204 Countries and Territories, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.","authors":"Baiqi Liu, Xinge Zhang, Jiarong Li, Zefang Sun, Chiayen Lin, Caihong Ning, Xiaoyue Hong, Shuai Zhu, Dingcheng Shen, Lu Chen, Gengwen Huang","doi":"10.1007/s10620-025-08996-y","DOIUrl":"https://doi.org/10.1007/s10620-025-08996-y","url":null,"abstract":"<p><strong>Background: </strong>Pancreatitis, an inflammatory condition of the pancreas, poses a significant global health burden. This study provides up-to-date global, regional, and national estimates of pancreatitis burdens from 1990 to 2021, focusing on disparities and trends across regions, age groups, and sexes.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease (GBD) 2021 study were analyzed to assess the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) associated with pancreatitis. Trends over the 32-year period were examined across demographics and geographic regions. Average annual percentage changes (AAPC) with 95% confidence intervals (CI) were calculated.</p><p><strong>Results: </strong>In 2021, the age-standardized rates (95% uncertainty interval) per 100,000 population for pancreatitis were: prevalence 69.0 (51.3, 91.3), incidence 32.8 (28.9, 37.4), deaths 1.5 (1.3, 1.7), and DALYs 48.4 (43.1, 55.3). Eastern Europe had the highest burden, led by the Russian Federation. From 1990 to 2021, global pancreatitis burden decreased with AAPCs (95% CI) of - 1.0% (- 1.1%, - 1.0%) for prevalence, - 0.4% (- 0.5%, - 0.4%) for incidence, - 0.5% (- 0.6%, - 0.3%) for deaths, and - 0.5% (- 0.6%, - 0.4%) for DALYs. Most regions showed declines, except Eastern Europe and parts of Africa. The elderly, particularly those aged 65 and older, faced the highest burden. An upward incidence trend was noted in those aged 15 to 25. Men exhibited higher burden rates, with the peak burden occurring at younger ages compared to women. High alcohol use contributed to 15.2% of deaths and 17.0% of DALYs related to pancreatitis.</p><p><strong>Conclusions: </strong>This study offers a comprehensive assessment of the global burden of pancreatitis from 1990 to 2021. Despite an overall decline, significant regional and demographic disparities persist, with Eastern Europe remaining disproportionately affected. The high burden among the elderly and rising incidence among the young highlight the need for targeted prevention, early detection, and management strategies.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718388","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}