Digestive Diseases and Sciences最新文献_第9页

Hepatocellular Carcinoma in Acute Porphyria: Incidence and Risk Factors. 急性卟啉症的肝细胞癌：发病率和危险因素。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-26 DOI: 10.1007/s10620-025-08959-3

Mattias Lissing, Pauline Harper, Staffan Wahlin

引用次数: 0

Lipidated IL-22 Alone or Combined with Immunomodulatory Agents Improves Disease Endpoints and Promotes Mucosal Healing in a Mouse Model of Chronic Dextran Sodium Sulfate-Induced Colitis. 脂化IL-22单独或联合免疫调节剂改善慢性右旋糖酐硫酸钠诱导结肠炎小鼠模型的疾病终点并促进粘膜愈合。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-26 DOI: 10.1007/s10620-025-09007-w

Sidsel Støy, Silvia D'Alessio, Thomas Damgaard Sandahl, Anders Dige, Anne Louise Kjølbye, Rasmus Jorgensen, Silvio Danese, Martijn van de Bunt

{"title":"Lipidated IL-22 Alone or Combined with Immunomodulatory Agents Improves Disease Endpoints and Promotes Mucosal Healing in a Mouse Model of Chronic Dextran Sodium Sulfate-Induced Colitis.","authors":"Sidsel Støy, Silvia D'Alessio, Thomas Damgaard Sandahl, Anders Dige, Anne Louise Kjølbye, Rasmus Jorgensen, Silvio Danese, Martijn van de Bunt","doi":"10.1007/s10620-025-09007-w","DOIUrl":"https://doi.org/10.1007/s10620-025-09007-w","url":null,"abstract":"Background: IL-22 facilitates mucosal healing by directly inducing epithelial regeneration and barrier integrity, which is essential for achieving remission and thereby treating inflammatory bowel disease.Aims: Here, we evaluated efficacy of a novel lipidated IL-22 alone and in combination with immunomodulatory agents in addressing chronic dextran sodium sulfate (DSS)-induced colitis in mice and demonstrated action of IL-22 on mucosal healing.Methods: Mice were treated with DSS, followed by various doses of lipidated IL-22, anti-TNF antibody, fingolimod, or anti-mouse α4β7 integrin antibody. Additionally, gene expression was determined in colonic biopsies from ulcerative colitis patients to assess effects of IL-22 stimulation.Results: Lipidated IL-22 significantly improved all aspects of chronic DSS-induced colitis in mice, with dose-dependent efficacy. Combinations of a range of immunomodulatory agents with lipidated IL-22 showed further additive reductions in disease activity, significantly greater than those of monotherapies. Immunohistochemistry revealed that lipidated IL-22 increased epithelial cell proliferation and reduced CD3+ T-cell infiltration, indicating enhanced mucosal healing. This was further supported gene expression data from colonic biopsies from ulcerative colitis patients after IL-22 stimulation.Conclusions: Given the challenges in achieving long-term remission in IBD due to inflammation and mucosal damage, lipidated IL-22 presents a promising treatment option that directly promotes mucosal healing, unlike traditional immunomodulatory therapies.","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":"143729333","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 New Simple Scoring System for Early Prediction of Severe Acute Pancreatitis. 一种新的简单评分系统用于早期预测重症急性胰腺炎。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-25 DOI: 10.1007/s10620-025-09010-1

Ali Can Kurtipek, Yusufcan Yılmaz, Tolga Canlı, Mevlüt Hamamcı

{"title":"A New Simple Scoring System for Early Prediction of Severe Acute Pancreatitis.","authors":"Ali Can Kurtipek, Yusufcan Yılmaz, Tolga Canlı, Mevlüt Hamamcı","doi":"10.1007/s10620-025-09010-1","DOIUrl":"https://doi.org/10.1007/s10620-025-09010-1","url":null,"abstract":"Background/objectives: Acute pancreatitis (AP) is an inflammatory condition with rising incidence, often resulting in severe complications and increased mortality, particularly when accompanied by organ failure. Early identification of patients at risk for severe AP is essential for timely intervention. Current scoring systems like Ranson's, BISAP, and APACHE-II, though useful, have limitations in terms of time and specificity. We aimed to identify a simple and early scoring system to predict severe AP.Methods: In this single-center study conducted over two years, patients diagnosed with AP within 72 h of symptom onset were enrolled. Initial clinical and laboratory data were prospectively collected according to established criteria, including BISAP, APACHE-II, and Ranson's. Multivariate logistic regression analyses were performed to identify independent risk factors for severe AP, which were then used to develop a new scoring system.Results: In our population of 424 patients (8.5% severe), we identified key clinical and laboratory markers-blood urea nitrogen (BUN), neutrophil-to-lymphocyte ratio (NLR), and heart rate-as independent predictors of severe AP. Based on these factors, we developed the BHN scoring system, which demonstrated non-inferior sensitivity (91.7%) and specificity (83.3%) for predicting severe disease, compared to more complex systems BISAP, Ranson's, and APACHE-II.Conclusion: The BHN score offers a simple, accessible tool in a variety of clinical settings, improving early risk stratification. External validation and further exploration of its use in mortality prediction are needed, but BHN presents a promising alternative for guiding early treatment decisions in acute pancreatitis.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709385","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

Outcomes of Colonic Endoscopic Submucosal Dissection and Advanced Tissue Resection in Obese Patients: An Analysis of a Large Western Cohort. 结肠内镜下粘膜夹层和晚期组织切除术治疗肥胖患者的结果：一项大型西方队列分析。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-25 DOI: 10.1007/s10620-025-08990-4

Tara Keihanian, Mai Khalaf, Fares Ayoub, Elaheh Keivani Boroujeni, Salmaan A Jawaid, Mohamed O Othman

{"title":"Outcomes of Colonic Endoscopic Submucosal Dissection and Advanced Tissue Resection in Obese Patients: An Analysis of a Large Western Cohort.","authors":"Tara Keihanian, Mai Khalaf, Fares Ayoub, Elaheh Keivani Boroujeni, Salmaan A Jawaid, Mohamed O Othman","doi":"10.1007/s10620-025-08990-4","DOIUrl":"https://doi.org/10.1007/s10620-025-08990-4","url":null,"abstract":"Background and aim: Colonic endoscopic submucosal dissection (ESD) and advanced tissue resection (ATR) in obese patients present challenges, including limited scope maneuverability, instability from abdominal fat, and slower dissection due to poor conductivity of submucosal fat. This study aims to assess the impact of obesity on colonic ESD outcomes in a large Western cohort.Method: This retrospective study analyzed patients who underwent colonic ESD and ATR at a US tertiary institution from April 2017 to July 2024. Patients were categorized by body mass index (BMI): control (< 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obese (≥ 30 kg/m2). Multinomial logistic regression and univariate analysis were performed to evaluate the impact of weight status on clinical success, procedure time, and adverse events.Results: A total of 637 patients were included (Control: 175, Overweight: 227, Obese: 235). En bloc resection (86.9% vs. 82.4% vs. 85.1%, P = 0.77) and R0 resection (78.9% vs. 72.2% vs. 74.5%, P = 0.16) were similar across groups. Obese patients had a significantly lower R0 resection rate for left-sided colonic lesions (P = 0.046). Also, obese patients more frequently required an overtube for dissection, especially for right-sided lesions (80% vs. 66%, P = 0.04). Procedure times were similar (P = 0.445), and 74.4% were safely discharged on the same day. Lack of defect closure (OR 3.072, CI 1.382-6.828) and longer procedure time (OR 1.017, CI 1.011-1.023) predicted post-procedure admission. No significant differences in adverse events were observed.Conclusion: Obese patients had a significantly lower R0 resection rate for left-sided colonic lesions and frequently required an overtube to facilitate the dissection of right-sided colonic lesions.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709389","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

Successful Closure of Duodenal Bulb Perforation Using a Detachable Over-the-Scope Clip. 使用可拆卸的镜外夹成功关闭十二指肠球穿孔。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-24 DOI: 10.1007/s10620-025-09002-1

Wenfeng Huang, Suhuan Liao, Silin Huang, Bingsheng Li

引用次数: 0

Agile 3+ and 4 Scores Accurately Predict Major Adverse Liver Outcomes, Liver Transplant, Progression of MELD Score, the Development of Hepatocellular Carcinoma, and Death in NAFLD. Agile 3+和4评分准确预测NAFLD的主要不良肝脏结局、肝移植、MELD评分进展、肝细胞癌发展和死亡。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-24 DOI: 10.1007/s10620-025-08850-1

Emily Truong, Lynna Alnimer, Jeffrey A Gornbein, Ju Dong Yang, Naim Alkhouri, Stephen A Harrison, Mazen Noureddin

{"title":"Agile 3+ and 4 Scores Accurately Predict Major Adverse Liver Outcomes, Liver Transplant, Progression of MELD Score, the Development of Hepatocellular Carcinoma, and Death in NAFLD.","authors":"Emily Truong, Lynna Alnimer, Jeffrey A Gornbein, Ju Dong Yang, Naim Alkhouri, Stephen A Harrison, Mazen Noureddin","doi":"10.1007/s10620-025-08850-1","DOIUrl":"https://doi.org/10.1007/s10620-025-08850-1","url":null,"abstract":"Background and aims: Based on liver stiffness measurement by vibration controlled transient elastography (LSM by VCTE), the Agile 3+ and 4 are novel noninvasive scores that accurately identify advanced fibrosis (≥ F3) and cirrhosis (F4), respectively. We investigated and compared the Agile 3+ and 4 scores' performances in predicting adverse events to LSM alone, FIB-4 and Fibroscan-AST (FAST) score.Method: This retrospective analysis included NAFLD patients with LSM by VCTE and laboratory testing from a tertiary care center from 2013 to 2022. Adverse events were defined as major adverse liver outcomes (MALO), hepatocellular carcinoma, liver transplant, and death. MALO was defined as ascites, hepatic encephalopathy, or esophageal variceal bleeding. We used the Cox proportional hazard rate model and the Harrell's concordance (C) statistic to compare predictive performances.Results: 733 total subjects with median follow-up of 27.0 months were included. Average age was 58.1 years and 32.8% had type 2 diabetes. Average alanine aminotransferase was 46.6 IU/L, aspartate aminotransferase: 34.5 IU/L, albumin: 4.4 g/dL, and platelets: 241.1 × 109/L. Fourteen subjects had 21 adverse outcomes, including 10 MALO, 5 HCC, 4 liver transplants, 3 progression of MELD score, and 6 deaths. Agile 3+ and 4 respectively had the highest C stats of 0.911 (C stat SE 0.028) and 0.909 (C stat SE 0.029) compared to LSM (C stat 0.857, C stat SE 0.045), FIB-4 (C stat 0.843, C stat SE 0.037) or FAST (C stat 0.703, C stat SE 0.085).Conclusion: The Agile 3+ and 4 scores had the highest likelihood of accurately predicting adverse outcomes including MALO and death compared to LSM alone, FIB-4 or FAST score.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699915","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 Case of Uterine Adenosarcoma and Colonic Endometriosis Masquerading as Inflammatory Bowel Disease. 伪装成炎症性肠病的子宫腺肉瘤和结肠子宫内膜异位症1例。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-21 DOI: 10.1007/s10620-025-08988-y

Chia-Jou Lin, Ying-Cheng Chiang, Tung-Hung Su, I-Lun Shih, Kuan-Ting Kuo, Shu-Chen Wei, Yi-Jou Tai

{"title":"A Case of Uterine Adenosarcoma and Colonic Endometriosis Masquerading as Inflammatory Bowel Disease.","authors":"Chia-Jou Lin, Ying-Cheng Chiang, Tung-Hung Su, I-Lun Shih, Kuan-Ting Kuo, Shu-Chen Wei, Yi-Jou Tai","doi":"10.1007/s10620-025-08988-y","DOIUrl":"https://doi.org/10.1007/s10620-025-08988-y","url":null,"abstract":"Background: Endometriosis is a prevalent gynecological condition that primarily affects women of reproductive age. When the gastrointestinal system is involved, it can lead to bowel dysfunction and pose diagnostic challenges.Aims: To present a rare case of gastrointestinal endometriosis with concurrent uterine adenosarcoma, highlighting the diagnostic complexities and therapeutic considerations.Methods: A 42-year-old female presented with refractory bloody diarrhea, abdominal pain, and significant unintentional weight loss for several months. Initial investigations, including stool studies and inflammatory markers, ruled out infectious and common inflammatory causes. Endoscopic evaluation revealed multiple polypoid lesions, prompting further imaging. Magnetic resonance enterography (MRE) identified a uterine mass with suspected extrauterine involvement and a rectal nodule, raising concerns for malignancy or extensive gastrointestinal endometriosis. The patient underwent surgical management, including total hysterectomy, bilateral salpingo-oophorectomy, and lower anterior resection.Results: Histopathological analysis confirmed the coexistence of uterine adenosarcoma and rectal endometriosis. The patient fully recovered after surgery without complications. At her 12-month follow-up, she remained asymptomatic, with no evidence of recurrence or residual disease.Conclusions: This case underscores the diagnostic and therapeutic challenges of gastrointestinal endometriosis, particularly in the presence of coexisting malignancy. A multidisciplinary approach is essential for early recognition and prompt intervention, which are crucial for improving patient outcomes and quality of life.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676917","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 Case of Minute Signet-Ring Cell Carcinoma Arising in Autoimmune Gastritis. 自身免疫性胃炎并发微小印戒细胞癌1例。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-21 DOI: 10.1007/s10620-025-08986-0

Kajie He, Li Tan, Suhuan Liao, Haining Cai, Silin Huang

引用次数: 0

Low Rates of Diagnosis and Treatment of Iron Deficiency Anemia After an Acute Severe Gastrointestinal Hemorrhage. 急性严重消化道出血后缺铁性贫血的诊断和治疗率低。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-21 DOI: 10.1007/s10620-025-08974-4

Elissa S Lin, Usah Dutson, Dennis M Jensen

{"title":"Low Rates of Diagnosis and Treatment of Iron Deficiency Anemia After an Acute Severe Gastrointestinal Hemorrhage.","authors":"Elissa S Lin, Usah Dutson, Dennis M Jensen","doi":"10.1007/s10620-025-08974-4","DOIUrl":"10.1007/s10620-025-08974-4","url":null,"abstract":"Background: Few studies report about management of iron deficiency anemia after a severe, acute gastrointestinal bleed. Most include good risk patients with upper gastrointestinal bleeds and report only laboratory improvements but not clinical outcomes.Aims: To assess management of iron deficiency anemia and clinical outcomes of patients after a severe, acute gastrointestinal bleed from either upper or lower sources in an unselected group of patients.Methods: Retrospective analysis of adult patients hospitalized with severe gastrointestinal bleeding in two referral centers. They had endoscopic diagnoses of lesions including non-variceal upper, variceal, and lower sites (diverticulosis or other colon sources). Analyses were of rates of iron studies ordered and iron treatments up to 4 months post-discharge. Composite clinical outcomes were also assessed and analyzed.Results: For 337 patients studied, iron studies were ordered in only 50%. When tested, iron deficiency was diagnosed in 75% of anemias. Intravenous iron or oral iron was prescribed in only 7.1% and 26.7% of patients, respectively. By 4 months, 94% of patients treated with intravenous iron and 80% treated with oral iron achieved ≥ 2 g/dL increase in hemoglobin level. Patients with high rates of severe co-morbidities and severe anemia had poor clinical outcomes although most were not treated for IDA.Conclusions: Despite significant anemia after a severe gastrointestinal bleed from common diagnoses, iron studies were not routinely ordered. Iron deficiency anemia was infrequently recognized or treated with iron therapies. Patients with severe co-morbidities and anemia after an acute gastrointestinal bleed had poor clinical outcomes.","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676959","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

Evaluating New Non-invasive Screening Tests for Colorectal Cancer: An In-Depth International Perspective-Introduction to a Special Issue of Digestive Diseases and Sciences. 评估结直肠癌新的非侵入性筛查试验：深入的国际视角-消化疾病与科学特刊介绍。

IF 2.5 4区医学

Digestive Diseases and Sciences Pub Date : 2025-03-21 DOI: 10.1007/s10620-025-08934-y

Robert S Bresalier, Graeme P Young, Carlo Senore

引用次数: 0