Expert Review of Gastroenterology & Hepatology最新文献_第2页

PSC patient with jaundice - should we ERCP? 伴有黄疸的PSC患者-是否应该进行ERCP？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-06 DOI: 10.1080/17474124.2025.2450723

Muhammad Umair Tayyub, Deepak Joshi

引用次数: 0

Antireflux surgery - choosing the right candidate. 抗反流手术-选择合适的人选。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-05 DOI: 10.1080/17474124.2024.2449455

André J Smout, Marlies P Schijven, Albert J Bredenoord

{"title":"Antireflux surgery - choosing the right candidate.","authors":"André J Smout, Marlies P Schijven, Albert J Bredenoord","doi":"10.1080/17474124.2024.2449455","DOIUrl":"https://doi.org/10.1080/17474124.2024.2449455","url":null,"abstract":"Introduction: Surgical gastric fundoplication is an effective treatment option for gastroesophageal reflux disease. In contrast to acid suppression, fundoplication nearly abolishes all types of reflux, acid and nonacid. However, in some cases lasting side effects of the procedure may overshadow its positive effects. It has remained difficult to determine which patients are the most suitable candidates for fundoplication.Areas covered: This review aims to evaluate the available data on preoperative factors that are associated with the outcome of fundoplication and to determine which combination of patient characteristics and preoperative test results provides optimal selection. In addition, we assess the need for tailoring the procedure on the basis of the preoperative quality of esophageal peristalsis.Expert opinion: Surgical treatment of gastroesophageal reflux disease is underutilized as it may provide an excellent option for a subset of GERD patients. It is not sensible to restrict surgical treatment to patients who do not respond to acid suppression. However, meticulous patient selection is key. Most importantly, surgical treatment should not be considered in patients in whom there is no convincing evidence that the symptoms are caused by reflux. Impaired esophageal peristalsis should not be regarded as a contraindication against fundoplication.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Acute severe ulcerative colitis: defining the precise moment for colectomy. 急性严重溃疡性结肠炎：确定结肠切除术的精确时机。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-03 DOI: 10.1080/17474124.2024.2448451

Paulo Gustavo Kotze, Sailish Honap, Mariane Christina Savio, Rafaela Molteni Moretti Araújo, Abel Botelho Quaresma, Laurent Peyrin-Biroulet

{"title":"Acute severe ulcerative colitis: defining the precise moment for colectomy.","authors":"Paulo Gustavo Kotze, Sailish Honap, Mariane Christina Savio, Rafaela Molteni Moretti Araújo, Abel Botelho Quaresma, Laurent Peyrin-Biroulet","doi":"10.1080/17474124.2024.2448451","DOIUrl":"https://doi.org/10.1080/17474124.2024.2448451","url":null,"abstract":"Introduction: Acute severe ulcerative colitis (ASUC) is a critical manifestation of ulcerative colitis (UC), often necessitating colectomy when medical management fails. Despite advancements in therapeutic interventions such as corticosteroids, biologics, and JAK inhibitors, a significant proportion of patients require surgery, with colectomy rates ranging from 10% to 15%.Areas covered: This paper reviews the factors influencing the timing and necessity of colectomy in ASUC management, emphasizing the importance of multidisciplinary decision-making involving gastroenterologists and surgeons.Expert opinion: Key surgical indications include failure of medical therapy, toxic megacolon, perforation, uncontrolled bleeding, and systemic deterioration. Delays in surgery can result in higher morbidity and mortality rates, making timely intervention essential. This review highlights surgical techniques, including total colectomy and end ileostomy, and discusses potential complications, urging a balanced approach to optimize patient outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Exploring immunological perturbations between hepatocellular carcinoma risk, inflammation and obesity. 探讨肝细胞癌风险、炎症和肥胖之间的免疫扰动。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-21 DOI: 10.1080/17474124.2024.2444557

Elsa Vitale, Alessandro Rizzo, Oronzo Brunetti, Giovanni Brandi

引用次数: 0

UK medical cannabis registry: an updated analysis of clinical outcomes of cannabis-based medicinal products for inflammatory bowel disease. 英国医用大麻登记处：对以大麻为基础的药物治疗炎症性肠病临床结果的最新分析。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2025-01-09 DOI: 10.1080/17474124.2024.2443574

Aashray Gupta, Simon Erridge, Vivian Graf, Monica Kelada, Lara Bapir, Naveen Jesuraj, John Warner-Levy, Evonne Clarke, Katy McLachlan, Ross Coomber, James J Rucker, Michael W Platt, Mikael H Sodergren

{"title":"UK medical cannabis registry: an updated analysis of clinical outcomes of cannabis-based medicinal products for inflammatory bowel disease.","authors":"Aashray Gupta, Simon Erridge, Vivian Graf, Monica Kelada, Lara Bapir, Naveen Jesuraj, John Warner-Levy, Evonne Clarke, Katy McLachlan, Ross Coomber, James J Rucker, Michael W Platt, Mikael H Sodergren","doi":"10.1080/17474124.2024.2443574","DOIUrl":"10.1080/17474124.2024.2443574","url":null,"abstract":"Background: Treatments for inflammatory bowel disease (IBD) remain limited, and cannabis-based medicinal products (CBMPs) provide promise in addressing inflammation and pain. However, long-term data on CBMP efficacy in IBD are scarce. This study examines health-related quality of life (HRQoL) changes in IBD patients treated with CBMPs.Research design and methods: Patients with IBD were identified from the UK Medical Cannabis Registry. Primary outcomes were changes in the short IBD questionnaire (SIBDQ), EQ-5D-5L, single-item sleep quality scale (SQS), and generalized anxiety disorder-7 (GAD-7), from baseline to 18-months after CBMP treatment started. Secondary outcomes were adverse event prevalence.Results: Analysis of 116 patients with IBD included 94 males (81.03%) with a mean age of 39.52 ± 9.12 years. There were improvements in the SIBDQ, GAD-7, SQS, and EQ-5D-5L Index (p < 0.001). At 18-months, 30 (25.86%) patients achieved a minimal clinically important difference (MCID) in the SIBDQ. Patients with severe baseline anxiety and above-median THC doses were more likely to achieve this MCID (p < 0.050). Twenty (17.24%) patients reported 155 (133.62%) adverse events.Conclusions: CBMP treatment was associated with improvement in IBD-specific outcomes in patients and general HRQoL over 18-months. However, causation cannot be inferred. Hence, randomized controlled trials are still required.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"829-838"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Extraintestinal complications of celiac disease: treatment considerations. 乳糜泻的肠外并发症：治疗考虑。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-25 DOI: 10.1080/17474124.2024.2443053

Pilar Lazzano, Elia Fracas, Nicoletta Nandi, Lucia Scaramella, Luca Elli

{"title":"Extraintestinal complications of celiac disease: treatment considerations.","authors":"Pilar Lazzano, Elia Fracas, Nicoletta Nandi, Lucia Scaramella, Luca Elli","doi":"10.1080/17474124.2024.2443053","DOIUrl":"10.1080/17474124.2024.2443053","url":null,"abstract":"Introduction: Celiac disease (CD) is an autoimmune enteropathy characterized by atrophy of the intestinal mucosa triggered by the ingestion of gluten in individuals with a genetic predisposition. CD manifests with heterogeneous array of symptoms, including a wide range of intestinal and extraintestinal symptoms and manifestations (EIMs). The mechanisms involved in the pathogenesis of EIMs in CD are not only related to intestinal mucosal damage and associated malabsorption but also to systemic inflammation. To date, the only effective treatment for CD is a lifelong gluten-free diet (GFD). Proper adherence to the GFD leads in most cases to a gradual resolution of intestinal atrophy and results in an improvement of the clinical manifestations associated with intestinal damage.Areas covered: This review, based on a Pubmed literature search, describes the extraintestinal complications associated with CD, emphasizing strategies for therapeutic management and responsiveness to the GFD.Expert opinion: CD is associated with different EIMs which can affect different organs. The main clinical interest is if these complications respond to the GFD, which occur at variable rate and not for all disorders associated with CD. Therefore, often complementary additional therapies are needed to achieve optimal symptoms resolution.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"761-777"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Revisiting septic shock in cirrhosis: a call for personalized management. 肝硬化脓毒性休克的再诊：个体化治疗的呼吁。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2025-01-02 DOI: 10.1080/17474124.2024.2443813

Vishnu Girish, Rakhi Maiwall

{"title":"Revisiting septic shock in cirrhosis: a call for personalized management.","authors":"Vishnu Girish, Rakhi Maiwall","doi":"10.1080/17474124.2024.2443813","DOIUrl":"10.1080/17474124.2024.2443813","url":null,"abstract":"Introduction: Patients with cirrhosis are known to be prone to infections. Infections can trigger organ failures and decompensations in cirrhosis. Septic shock can increase mortality by fourfold and cause hemodynamic imbalances, adding to the already hyperdynamic circulation. Management of septic shock in cirrhosis can be tricky due to this complex interplay of altered hemodynamics, immune function, and coagulation.Areas covered: In this review, we explore the pathophysiological basis, screening, monitoring and management of septic shock in cirrhosis. We also explore novel biomarkers, the growing challenge of multidrug-resistant pathogens and novel and adjunctive therapies. Finally, we propose an algorithm for the management of septic shock in cirrhosis. We conducted a comprehensive search of electronic databases such as PubMed, Web of Science, and Cochrane Library using the keywords and MeSH terms like 'septic shock,' 'cirrhosis,' 'liver disease,' 'sepsis' among others. The search was restricted to peer-reviewed articles in English.Expert opinion: The difficulties in managing septic shock in cirrhosis are discussed, emphasizing personalized approaches over protocol-driven care. Fluid and vasopressor management, antibiotic timing and selection, the role of adjunctive therapies, the importance of lactate clearance, gut failure, and the need for further research in this population are highlighted.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"795-813"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

When to refer patients for liver elastography. 何时转介病人作肝弹性造影。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-19 DOI: 10.1080/17474124.2024.2444554

Roxana Sirli, Ioan Sporea, Alina Popescu

引用次数: 0

The assessment of impaired liver function and prognosis in hepatocellular carcinoma. 肝细胞癌肝功能损害及预后评估。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2025-01-07 DOI: 10.1080/17474124.2024.2442573

Roxana Pantea, Jan Bednarsch, Sophia Schmitz, Phil Meister, Daniel Heise, Florian Ulmer, Ulf Peter Neumann, Sven Arke Lang

{"title":"The assessment of impaired liver function and prognosis in hepatocellular carcinoma.","authors":"Roxana Pantea, Jan Bednarsch, Sophia Schmitz, Phil Meister, Daniel Heise, Florian Ulmer, Ulf Peter Neumann, Sven Arke Lang","doi":"10.1080/17474124.2024.2442573","DOIUrl":"10.1080/17474124.2024.2442573","url":null,"abstract":"Introduction: The impairment of liver function strongly limits the therapeutic options for hepatocellular carcinoma (HCC), and the assessment of liver function is key to finding the appropriate therapy for patients suffering from this disease. Furthermore, preexisting liver dysfunction has a negative impact on the prognosis of patients in addition to the malignant potential of HCC. Hence, defining the optimal treatment of patients with HCC requires a comprehensive examination with liver function being a crucial part of it.Areas covered: This review will provide an overview of the currently existing methods for evaluating the liver function in patients with HCC. Assessment of liver function includes scoring systems but also functional and technical methods. In addition, the role of these tests in different treatment facilities such as liver resection, transplantation, interventional and systemic therapy is summarized.Expert opinion: A comprehensive pretherapeutic assessment of the liver function includes laboratory-based scoring systems, as well as imaging- and non-imaging-based functional tests. Combining diverse parameters can help to improve the safety and efficacy of HCC therapy particularly in patients with compromised liver function. Future research should focus on optimizing pretherapeutic assessment recommendations for each therapy.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"779-794"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Advancements in the management of pediatric inflammatory bowel disease. 儿童炎症性肠病的治疗进展。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2024-12-23 DOI: 10.1080/17474124.2024.2444555

Jonathan E M O'Donnell, Thomas D Walters, Eric I Benchimol

{"title":"Advancements in the management of pediatric inflammatory bowel disease.","authors":"Jonathan E M O'Donnell, Thomas D Walters, Eric I Benchimol","doi":"10.1080/17474124.2024.2444555","DOIUrl":"10.1080/17474124.2024.2444555","url":null,"abstract":"Introduction: The management of pediatric inflammatory bowel disease (PIBD) has drastically changed in the last decade. The limited availability of new biologics or small molecule therapies, and concerns about durability in children has necessitated the development of other advances in management to optimize care.Areas covered: This review covers guidance for management targets and advances in optimizing biologic therapies, new medical therapies, adjuvant therapies, precision medicine and mental health concerns in PIBD. This review focused on recent advances and was not intended as a complete overview of the investigations and management of pediatric IBD.Expert opinion: Advancements include standardization of treatment goals via a treat-to-target strategy, optimizing anti-TNF biologics through combination therapy or proactive drug monitoring, earlier initiation of treatment for Crohn's disease, the emergence of new biologic/advanced therapies and a growing focus on adjuvant therapies targeting the microbiome. Future progress relies on the inclusion of children/adolescents in clinical trials to facilitate faster regulatory approval for pediatric therapies and the integration of precision medicine and mental health screening to improve patient care and outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"815-827"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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