Expert Review of Gastroenterology & Hepatology最新文献_第4页

Incidence and risk factors of acute kidney injury in cirrhosis: a systematic review and meta-analysis of 5,202,232 outpatients, inpatients, and ICU-admitted patients. 肝硬化急性肾损伤的发病率和风险因素：对 520232 名门诊病人、住院病人和入住重症监护室病人的系统回顾和荟萃分析。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-07-16 DOI: 10.1080/17474124.2024.2380299

Vasileios Lekakis, Aikaterini Gkoufa, John Vlachogiannakos, George V Papatheodoridis, Evangelos Cholongitas

{"title":"Incidence and risk factors of acute kidney injury in cirrhosis: a systematic review and meta-analysis of 5,202,232 outpatients, inpatients, and ICU-admitted patients.","authors":"Vasileios Lekakis, Aikaterini Gkoufa, John Vlachogiannakos, George V Papatheodoridis, Evangelos Cholongitas","doi":"10.1080/17474124.2024.2380299","DOIUrl":"10.1080/17474124.2024.2380299","url":null,"abstract":"Introduction: Acute kidney injury (AKI) is a commonly seen condition in the natural course of cirrhosis. The aim of this study was to evaluate the pooled incidence and risk factors of AKI in different clinical stages and situations in patients with cirrhosis.Methods: Search was conducted on 13 December 2023 across MEDLINE (PubMed), Embase, and Cochrane databases. Meta-analysis was performed using a generalized linear mixed model.Results: In total, 73 studies with 5,202,232 patients were finally enrolled in the meta-analysis. AKI commonly occurs among hospitalized cirrhotics experiencing any decompensation event (29%) as well as among stable outpatients (28%) throughout a 1-year follow-up period. On admission, patients with infection or sepsis/septic shock had the highest AKI rate (47%), followed by those with hepatic encephalopathy (41%). Furthermore, the severity of liver disease proved to be a substantial driver for AKI development, while patients at intensive care unit had the greatest AKI incidence (61%).Conclusions: Both hospitalized patients and stable outpatients with cirrhosis exhibited an elevated susceptibility to AKI. Patients at intensive care unit and those with severe liver disease, infection, sepsis/septic shock, hepatic encephalopathy, or acute on chronic liver failure upon admission are at higher risk for AKI.Trial registration: PROSPERO, registered 09/12/23, CRD42023487736.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"377-388"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598912","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

Integrating behavioral interventions into a holistic approach to metabolic dysfunction-associated steatotic liver disease. 将行为干预纳入代谢功能障碍相关性脂肪肝的整体治疗方法。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-08-05 DOI: 10.1080/17474124.2024.2385487

Riccardo Righetti, Felice Cinque, Maria Teresa Volpe, Giada Sebastiani

{"title":"Integrating behavioral interventions into a holistic approach to metabolic dysfunction-associated steatotic liver disease.","authors":"Riccardo Righetti, Felice Cinque, Maria Teresa Volpe, Giada Sebastiani","doi":"10.1080/17474124.2024.2385487","DOIUrl":"10.1080/17474124.2024.2385487","url":null,"abstract":"Introduction: The therapeutic landscape of Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) is rapidly evolving with the FDA approval of resmetirom, the first authorized molecule to treat metabolic dysfunction-associated steatohepatitis. Clinical trials are investigating other promising molecules. However, this focus on pharmacotherapy may overshadow lifestyle interventions, which remain the cornerstone of MASLD management. A significant percentage of patients with MASLD struggle with an underlying eating disorder, often a precursor to obesity. The obesity pandemic, exacerbated by the increasing prevalence of binge eating, underscores the need for a psychological approach to address their common roots.Areas covered: We reviewed the current evidence on behavioral interventions for MASLD. Interventions such as self-monitoring, goal setting, and frequent counseling, have proven effective in achieving at least 5% weight loss. Cognitive behavioral therapy is the first-line treatment for eating disorders and has shown efficacy in treating binge eating and obesity. Further research is needed to establish the optimal behavioral therapy for MASLD, focusing on enhancing compliance and achieving sustained weight loss through diet and physical exercise.Expert opinion: The treatment of MASLD should not rely solely on pharmacotherapy targeting a single-organ manifestation. Instead, we must consider behavioral interventions, emphasizing the pivotal role of a holistic approach to this multifaceted disorder. [Figure: see text].","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"303-313"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792326","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

Update of gut gas metabolism in ulcerative colitis. 溃疡性结肠炎肠道气体代谢的最新进展。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-07-24 DOI: 10.1080/17474124.2024.2383635

Xiaohan Zhang, Xiuli Zhang, Yunsheng Yang

{"title":"Update of gut gas metabolism in ulcerative colitis.","authors":"Xiaohan Zhang, Xiuli Zhang, Yunsheng Yang","doi":"10.1080/17474124.2024.2383635","DOIUrl":"10.1080/17474124.2024.2383635","url":null,"abstract":"Introduction: Ulcerative colitis (UC) is a chronic, nonspecific inflammatory disease of the intestine. The intestinal microbiota is essential in the occurrence and development of UC. Gut gases are produced via bacterial fermentation or chemical interactions, which can reveal altered intestinal microbiota, abnormal cellular metabolism, and inflammation responses. Recent studies have demonstrated that UC patients have an altered gut gas metabolism.Areas covered: In this review, we integrate gut gas metabolism advances in UC and discuss intestinal gases' clinical values as new biomarkers or therapeutic targets for UC, providing the foundation for further research. Literature regarding gut gas metabolism and its significance in UC from inception to October 2023 was searched on the MEDLINE database and references from relevant articles were investigated.Expert opinion: Depending on their type, concentration, and volume, gut gases can induce or alleviate clinical symptoms and regulate intestinal motility, inflammatory responses, immune function, and oxidative stress, significantly impacting UC. Gut gases may function as new biomarkers and provide potential diagnostic or therapeutic targets for UC.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"339-349"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731035","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

Recent advances in treating constipation in children. 治疗儿童便秘的最新进展。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-07-25 DOI: 10.1080/17474124.2024.2383636

Sharon Wolfson, Miguel Saps

{"title":"Recent advances in treating constipation in children.","authors":"Sharon Wolfson, Miguel Saps","doi":"10.1080/17474124.2024.2383636","DOIUrl":"10.1080/17474124.2024.2383636","url":null,"abstract":"Introduction: Functional constipation (FC) is a common childhood condition, diagnosed via the Rome IV criteria. Standard therapy includes lifestyle and dietary modification followed by initiation of osmotic laxative therapy. About 30% of children continue to experience symptoms related to FC despite appropriate management. New pharmacologic, surgical, and neuromodulatory therapies for FC are now available for use in adult and pediatric populations. In 2023, the first pharmacologic agent, linaclotide, obtained FDA approval for treatment of FC in children 6-17 years old.Areas covered: This article reviews current and emerging pharmacologic, surgical, and neuromodulation therapies for the management of FC in pediatric patients. Efficacy and safety data regarding each of these modalities was reviewed and discussed.Expert opinion: Advancements in therapeutics available for the management of FC necessitate further investigation on safety and efficacy in pediatric populations. Careful consideration should be taken in choosing an available treatment with limited pediatric evidence as adult and pediatric FC have different underlying pathophysiology and require a different therapeutic approach. Standardization of methodology and pediatric endpoints are needed to optimize ability to compare efficacy of different treatments. We predict the future of pediatric FC management will include a personalized approach to care, resulting in improved outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"325-338"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733909","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

Endoscopic ultrasound-guided pancreatic duct drainage: a comprehensive state of the art review. 内镜超声引导下的胰管引流术：最新技术综述。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-07-23 DOI: 10.1080/17474124.2024.2383631

Jayanta Samanta, Abhirup Chatterjee, Jahnvi Dhar, Zaheer Nabi, Michiel Bronswijk, Manik Aggarwal, Antonio Facciorusso, Paraskevas Gkolfakis, Takeshi Ogura, Schalk Van der Merwe, Sundeep Lakhtakia

{"title":"Endoscopic ultrasound-guided pancreatic duct drainage: a comprehensive state of the art review.","authors":"Jayanta Samanta, Abhirup Chatterjee, Jahnvi Dhar, Zaheer Nabi, Michiel Bronswijk, Manik Aggarwal, Antonio Facciorusso, Paraskevas Gkolfakis, Takeshi Ogura, Schalk Van der Merwe, Sundeep Lakhtakia","doi":"10.1080/17474124.2024.2383631","DOIUrl":"10.1080/17474124.2024.2383631","url":null,"abstract":"Introduction: Endoscopic retrograde pancreatography (ERP) has traditionally been the standard modality for pancreatic endotherapy. However, in certain situations, failure of retrograde ductal access may warrant an alternative modality of drainage. This can occur in various settings like difficult and/or surgically altered anatomy or duodenal obstruction. Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD) is a relatively newer addition to the armamentarium for endoscopic access to the PD.Areas covered: This comprehensive state-of-art review aims to give an overview of the indications, technical details, different approaches, and outcomes of EUS-PDD, with the latest evidence available in scientific literature.Expert opinion: Akin to its biliary drainage counterpart, EUS-PDD enables an EUS-assisted-ERP using rendezvous technique or EUS-guided drainage through transmural stenting. The technique has evolved over the ensuing years with multitude of accessories, approaches, and devices to optimize the outcomes. However, the technical success and adverse events rates need to be further improved. Additionally, it has a steep learning curve with requirements of advanced technical skill and optimum infrastructure back-up. Meticulous patient selection, precise knowledge of ductal anatomy, appropriate approach, and carefully chosen accessories can improve its clinical outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"351-365"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747804","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

Novel approaches in the medical management of compensated cirrhosis. 代偿期肝硬化医疗管理的新方法。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-05-28 DOI: 10.1080/17474124.2024.2358149

Antonio Moreno-Loro, Álvaro Giráldez, Fernando Jiménez, Ignacio López-Bueno, Alberto Pérez-Ramírez, Manuel Romero-Gómez

{"title":"Novel approaches in the medical management of compensated cirrhosis.","authors":"Antonio Moreno-Loro, Álvaro Giráldez, Fernando Jiménez, Ignacio López-Bueno, Alberto Pérez-Ramírez, Manuel Romero-Gómez","doi":"10.1080/17474124.2024.2358149","DOIUrl":"10.1080/17474124.2024.2358149","url":null,"abstract":"Introduction: Classically, clinical practice guidelines and expert recommendations have focused on the management of decompensated cirrhotic patients, so we focused this review on improving care for compensated cirrhotic patients who are followed up in outpatient clinics.Areas covered: We reviewed the current methods for establishing liver function, the diagnosis and management of advanced chronic liver disease and clinically significant portal hypertension as well as the prevention of its complications, with special attention to covert hepatic encephalopathy, we also paid attention to the extrahepatic complications of cirrhosis and the palliative care. All this from the perspective of evidence-based medicine and trying to empower precision medicine. The literature search was undertaken by PubMed with 'cirrhosis,' 'advanced chronic liver disease,' 'liver function,' 'portal hypertension,' 'covert hepatic encephalopathy,' 'minimal hepatic encephalopathy,' 'palliative care' as MeSH terms.Expert opinion: We must offer compensated cirrhotic patients specific care and measures to prevent the progression of the disease and the appearance of its complications beyond the calculation of liver function and imaging screening for hepatocellular carcinoma that we perform every six months. Entities that have typically received little attention, such as covert hepatic encephalopathy, extrahepatic complications and symptoms of cirrhosis, and palliative care, must come to the spotlight.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"239-256"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087580","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

From NAFLD to MASLD: what does it mean? 从 NAFLD 到 MASLD：这意味着什么？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-07-01 DOI: 10.1080/17474124.2024.2374472

Lampros Chrysavgis, Evangelos Cholongitas

引用次数: 0

Recommendations for the management of gastrointestinal comorbidities with or without trofinetide use in Rett syndrome. 关于在雷特综合征中使用或不使用特罗菲奈肽治疗胃肠道合并症的建议。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-06-18 DOI: 10.1080/17474124.2024.2368014

Kathleen J Motil, Arthur Beisang, Constance Smith-Hicks, Anthony Lembo, Shannon M Standridge, Edwin Liu

{"title":"Recommendations for the management of gastrointestinal comorbidities with or without trofinetide use in Rett syndrome.","authors":"Kathleen J Motil, Arthur Beisang, Constance Smith-Hicks, Anthony Lembo, Shannon M Standridge, Edwin Liu","doi":"10.1080/17474124.2024.2368014","DOIUrl":"10.1080/17474124.2024.2368014","url":null,"abstract":"Introduction: Although gastrointestinal (GI) comorbidities are experienced by over 90% of individuals with Rett syndrome (RTT), a neurodevelopmental disorder associated with mutations in the MECP2 gene, many neurologists and pediatricians do not rank the management of these comorbidities among the most important treatment goals for RTT. Trofinetide, the first approved pharmacologic treatment for RTT, confers improvements in RTT symptoms but is associated with adverse GI events, primarily diarrhea and vomiting. Treatment strategies for GI comorbidities and drug-associated symptoms in RTT represent an unmet clinical need.Areas covered: This perspective covers GI comorbidities experienced by those with RTT, either with or without trofinetide treatment. PubMed literature searches were undertaken on treatment recommendations for the following conditions: constipation, diarrhea, vomiting, aspiration, dysphagia, gastroesophageal reflux, nausea, gastroparesis, gastritis, and abdominal bloating.Expert opinion: The authors recommend a proactive approach to management of symptomatic GI comorbidities and drug-associated symptoms in RTT to enhance drug tolerance and improve the quality of life of affected individuals. Management strategies for common GI comorbidities associated with RTT are reviewed based on authors' clinical experience and augmented by recommendations from the literature.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"227-237"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316930","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

Eosinophilic esophagitis in the era of biologics. 生物制剂时代的嗜酸性粒细胞食管炎。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-07-01 DOI: 10.1080/17474124.2024.2374471

Carlo Maria Rossi, Giovanni Santacroce, Marco Vincenzo Lenti, Antonio di Sabatino

{"title":"Eosinophilic esophagitis in the era of biologics.","authors":"Carlo Maria Rossi, Giovanni Santacroce, Marco Vincenzo Lenti, Antonio di Sabatino","doi":"10.1080/17474124.2024.2374471","DOIUrl":"10.1080/17474124.2024.2374471","url":null,"abstract":"Introduction: Eosinophilic esophagitis (EoE) is a chronic inflammatory, disabling disorder characterized by prominent eosinophilic inflammation of the esophagus, leading to troublesome symptoms including dysphagia and food impaction. The natural history of EoE is poorly known, but it may lead to esophageal strictures. The therapeutic armamentarium is expected to grow in the near future, especially due to the availability of novel biological therapies targeting crucial inflammatory pathways of EoE.Areas covered: In this review, we discuss the main clinical features and natural history of EoE, focusing on the current therapeutic strategies, as well as past and current trials investigating biologics for its treatment.Expert opinion: Dupilumab has been the first approved biologic drug for the treatment of EoE; long-term studies assessing how it could change the natural history of EoE are awaited. Novel biological drugs or other molecules are currently under study and could change the current treatment algorithms in the near future. Proper drug positioning and long term 'exit strategies' are yet to be defined.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"271-281"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467313","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

Endoscopic full thickness resection: techniques, applications, outcomes. 内窥镜全厚切除术：技术、应用和结果。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-06-01 Epub Date: 2024-05-24 DOI: 10.1080/17474124.2024.2357611

Zaheer Nabi, D Nageshwar Reddy

{"title":"Endoscopic full thickness resection: techniques, applications, outcomes.","authors":"Zaheer Nabi, D Nageshwar Reddy","doi":"10.1080/17474124.2024.2357611","DOIUrl":"10.1080/17474124.2024.2357611","url":null,"abstract":"Introduction: Endoscopic full-thickness resection (EFTR) represents a pivotal advancement in the minimally invasive treatment of gastrointestinal lesions, offering a novel approach for the management of lesions previously deemed challenging or unreachable through conventional endoscopic techniques.Areas covered: This review discusses the development, methodologies, applications, and clinical outcomes associated with EFTR, including exposed and device-assisted EFTR, the integration of endoscopic mucosal resection with EFTR in hybrid techniques, and the collaborative approach between laparoscopic and endoscopic surgery (LECS). It encapsulates a comprehensive analysis of the various EFTR techniques tailored to specific lesion characteristics and anatomical locations, underscoring the significance of technique selection based on the lesion's nature and situational context.Expert opinion/commentary: The review underscores EFTR's transformative role in expanding therapeutic horizons for gastrointestinal tumors, emphasizing the importance of technique selection tailored to the unique attributes of each lesion. It highlights EFTR's capacity to facilitate organ-preserving interventions, thereby significantly enhancing patient outcomes and reducing procedural complications. EFTR is a cornerstone in the evolution of gastrointestinal surgery, marking a significant leap forward in the pursuit of precision, safety, and efficacy in tumor management.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"257-269"},"PeriodicalIF":3.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080921","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