Expert Review of Gastroenterology & Hepatology最新文献_第6页

Mistakes in utilising histopathology for the management of liver disease. 利用组织病理学治疗肝病的误区。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2024-05-15 DOI: 10.1080/17474124.2024.2355168

Madunil Anuk Niriella, Dharani Kanagarajah, Janaki De Silva Hewavisenthi, H Janka de Silva

{"title":"Mistakes in utilising histopathology for the management of liver disease.","authors":"Madunil Anuk Niriella, Dharani Kanagarajah, Janaki De Silva Hewavisenthi, H Janka de Silva","doi":"10.1080/17474124.2024.2355168","DOIUrl":"10.1080/17474124.2024.2355168","url":null,"abstract":"Introduction: Liver biopsy has become selective due to its invasiveness, potential adverse effects, patient acceptance and cost. Furthermore, the emergence of noninvasive tests (NITs) has challenged the necessity of liver biopsies in specific clinical situations. However, liver biopsy continues to play a crucial role in disease diagnosis, prognosis, and evaluating treatment compliance and response in selected patients.Areas covered: In this narrative review, we discuss the errors and the shortcomings that can occur at various stages, from the initial patient selection for a liver biopsy to the final reporting phase, and strategies to address them. Clinicians and pathologists must take all necessary precautions to mitigate potential shortcomings that could compromise the value of liver biopsies.Expert opinion: The increasing sophistication of NITs offers a safer, more convenient, and potentially more cost-effective approach to diagnosing chronic liver disease, especially for assessing the degree of liver fibrosis. As NITs continue to evolve, liver biopsy will likely transition to a more targeted role, ensuring optimal patient care in the ever-changing field of hepatology. However, liver biopsy will continue to have a pivotal role in assessing acute liver disease where the diagnostic yield of the liver biopsy still outweighs that of NITs.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"147-153"},"PeriodicalIF":3.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920643","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

IBD in women of reproductive age: where do novel therapies fit in? 育龄妇女的肠道疾病：新疗法的适用范围？

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-04-01 Epub Date: 2024-03-22 DOI: 10.1080/17474124.2024.2334039

Melanie Cuffe, Christian P Selinger

引用次数: 0

Endoscopic ultrasound-guided radiofrequency ablation of pancreatic insulinoma: a state of the art review 内窥镜超声引导下的胰岛素瘤射频消融术：最新进展综述

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-02-21 DOI: 10.1080/17474124.2024.2321938

Jahnvi Dhar, Jayanta Samanta, Zaheer Nabi, Manik Aggarwal, Antonio Facciorusso, Maria Cristina Conti Bellocchi, Stefano Francesco Crinò

引用次数: 0

Optimizing ambulatory reflux monitoring: current findings and future directions. 优化流动反流监测：当前发现与未来方向。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2023-12-25 DOI: 10.1080/17474124.2023.2297919

Dhweeja Dasarathy, Michael Vaezi, Dhyanesh Patel

{"title":"Optimizing ambulatory reflux monitoring: current findings and future directions.","authors":"Dhweeja Dasarathy, Michael Vaezi, Dhyanesh Patel","doi":"10.1080/17474124.2023.2297919","DOIUrl":"10.1080/17474124.2023.2297919","url":null,"abstract":"Introduction: Gastroesophageal reflux disease (GERD) is the most common diagnosis seen in outpatient gastroenterology clinics. The diagnosis is made by a variable combination of symptoms, response to acid suppressive therapy, endoscopic evaluation, and pH testing. In this review, we evaluate how to utilize various reflux testing in clinical practice based on current evidence.Areas covered: Ambulatory reflux monitoring is a recognized diagnostic tool for clinical decision making in patients with/without established GERD, persistent reflux symptoms, and lack of response to proton pump inhibitor (PPI) therapy. Standard evaluation approaches include 24-hour pH or impedance monitoring via transnasal catheter, prolonged (48 to 96 hour) wireless pH monitoring, and the recently developed mucosal integrity testing. Testing using one of these methods allows for measurement of acid exposure, frequency of reflux, and to phenotype patients to personalize treatment recommendations.Expert opinion: The primary goal of future studies should be to simplify ambulatory reflux monitoring, reduce diagnostic latency, improve patient tolerance, and to obtain clinical outcomes-based studies. The current paradigm of reflux testing is vastly complex with multiple modalities and shifting cutoffs of pH abnormality that lead to high economic burden on the society.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"13-24"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032158","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

Correction. 更正。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-02-05 DOI: 10.1080/17474124.2024.2314810

引用次数: 0

Impact of the COVID-19 pandemic on hospitalizations with hepatocellular carcinoma in the United States. COVID-19 大流行对美国肝细胞癌住院治疗的影响。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-02-19 DOI: 10.1080/17474124.2024.2319580

Peter Konyn, Brandon J Perumpail, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed, Donghee Kim

{"title":"Impact of the COVID-19 pandemic on hospitalizations with hepatocellular carcinoma in the United States.","authors":"Peter Konyn, Brandon J Perumpail, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed, Donghee Kim","doi":"10.1080/17474124.2024.2319580","DOIUrl":"10.1080/17474124.2024.2319580","url":null,"abstract":"Background: We studied the temporal trends of hepatocellular carcinoma (HCC)-related hospitalizations and potential predictors of in-hospital mortality around the COVID-19 pandemic.Research design and methods: Using the International Classification of Diseases code, we used the National Inpatient Sample 2019-2020 and defined HCC and its underlying etiology. To assess the impact of the COVID-19 pandemic on hospitalization and in-hospital mortality, the study period was divided into the pre-COVID-19 era (2019 Q1-2020 Q1) and the COVID-19 era (2020 Q2-2020 Q4). Quarterly trends in etiology-based hospitalizations with HCC and predictors of in-hospital mortality among hospitalizations with HCC were determined.Results: Hospitalization rates for HCC, as well as viral hepatitis-related HCC hospitalization rates, remained stable, while hospitalizations with alcohol-related liver disease (ALD, quarterly percentage change [QPC]: 2.1%; 95% confidence interval [CI]: 0.1%-4.2%) increased steadily. Hospitalization related to nonalcoholic fatty liver disease (NAFLD)-related HCC increased significantly steeper in the COVID-19 era (QPC: 6.6%; 95% CI: 4.0%-9.3%) than in the pre-COVID-19 era (QPC: 0.7%; 95% CI: 0.2%-1.3%). COVID-19 infection was independently associated with in-hospital mortality among hospitalizations with HCC (odds ratio: 1.94, 95% CI: 1.30-2.88).Conclusion: Hospitalization rates for viral hepatitis-related HCC remained stable, while those for HCC due to ALD and NAFLD increased during the COVID-19 pandemic.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"113-119"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729416","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

Development and validation of modified Liaoning score for predicting the prognosis of liver cirrhosis: a retrospective, international multicenter, observational study. 用于预测肝硬化预后的改良辽宁评分的开发与验证：一项回顾性国际多中心观察研究。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-02-27 DOI: 10.1080/17474124.2024.2320238

Xiaoting Song, Fernando Gomes Romeiro, Jing Wang, Yue Yin, Cyriac Abby Philips, Xinyi Yang, Xiaofeng Liu, Wenming Wu, Marcos Vinícius Tiveli Bernardinelli, Roger Santos de Souza, Arif Hussain Theruvath, Su Lin, Xingshun Qi

{"title":"Development and validation of modified Liaoning score for predicting the prognosis of liver cirrhosis: a retrospective, international multicenter, observational study.","authors":"Xiaoting Song, Fernando Gomes Romeiro, Jing Wang, Yue Yin, Cyriac Abby Philips, Xinyi Yang, Xiaofeng Liu, Wenming Wu, Marcos Vinícius Tiveli Bernardinelli, Roger Santos de Souza, Arif Hussain Theruvath, Su Lin, Xingshun Qi","doi":"10.1080/17474124.2024.2320238","DOIUrl":"10.1080/17474124.2024.2320238","url":null,"abstract":"Background: Liaoning score has been developed and validated to predict the risk of esophageal varices in liver cirrhosis. This study aimed to further modify the Liaoning score by combining clinical and laboratory parameters to predict the long-term outcome of cirrhotic patients.Methods: First, 474 cirrhotic patients were retrospectively enrolled from Shenyang, China as the training cohort. Independent predictors for death were identified by competing risk analyses, and then a new prognostic model, called as modified Liaoning score, was developed. Its performance was externally validated at three centers from Fuzhou, China (n = 1944), Jinan, China (n = 485), and São Paulo, Brazil (n = 221).Results: Age, total bilirubin (TBIL), albumin (ALB), serum creatinine (SCr), and Liaoning score were independently associated with death in the training cohort. Modified Liaoning score = 0.159×Liaoning score + 0.010×TBIL(µmol/L)+0.029×age(years)+0.011×SCr(µmol/L)-0.037×ALB(g/L). The area under curve of modified Liaoning score was 0.714 (95%CI = 0.655-0.773), which was higher than that of Child-Pugh score (0.707, 95%CI = 0.645-0.770), MELD score (0.687, 95%CI = 0.623-0.751), and Liaoning score (0.583, 95%CI = 0.513-0.654). A modified Liaoning score of ≥ 1.296 suggested a higher cumulative incidence of death in liver cirrhosis (p < 0.001). Modified Liaoning score still had the highest prognostic performance in Chinese and Brazilian validation cohorts.Conclusions: Modified Liaoning score can be considered for predicting the long-term outcome of cirrhotic patients.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"121-128"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740829","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

Next-generation therapies for pancreatic cancer. 胰腺癌的新一代疗法。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-02-28 DOI: 10.1080/17474124.2024.2322648

Conor W Buckley, Eileen M O'Reilly

{"title":"Next-generation therapies for pancreatic cancer.","authors":"Conor W Buckley, Eileen M O'Reilly","doi":"10.1080/17474124.2024.2322648","DOIUrl":"10.1080/17474124.2024.2322648","url":null,"abstract":"Introduction: Pancreas ductal adenocarcinoma (PDAC) is a frequently lethal malignancy that poses unique therapeutic challenges. The current mainstay of therapy for metastatic PDAC (mPDAC) is cytotoxic chemotherapy. NALIRIFOX (liposomal irinotecan, fluorouracil, leucovorin, oxaliplatin) is an emerging standard of care in the metastatic setting. An evolving understanding of PDAC pathogenesis is driving a shift toward targeted therapy. Olaparib, a poly-ADP-ribose polymerase (PARP) inhibitor, has regulatory approval for maintenance therapy in BRCA-mutated mPDAC along with other targeted agents receiving disease-agnostic approvals including for PDAC with rare fusions and mismatch repair deficiency. Ongoing research continues to identify and evaluate an expanding array of targeted therapies for PDAC.Areas covered: This review provides a brief overview of standard therapies for PDAC and an emphasis on current and emerging targeted therapies.Expert opinion: There is notable potential for targeted therapies for KRAS-mutated PDAC with opportunity for meaningful benefit for a sizable portion of patients with this disease. Further, emerging approaches are focused on novel immune, tumor microenvironment, and synthetic lethality strategies.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"55-72"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric endoscopy: how can we improve patient outcomes and ensure best practices? 儿科内窥镜检查：如何改善患者预后并确保最佳操作？

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-03-12 DOI: 10.1080/17474124.2024.2328229

Lisa B Mahoney, Jeannie S Huang, Jenifer R Lightdale, Catharine M Walsh

{"title":"Pediatric endoscopy: how can we improve patient outcomes and ensure best practices?","authors":"Lisa B Mahoney, Jeannie S Huang, Jenifer R Lightdale, Catharine M Walsh","doi":"10.1080/17474124.2024.2328229","DOIUrl":"10.1080/17474124.2024.2328229","url":null,"abstract":"Introduction: Strategies to promote high-quality endoscopy in children require consensus around pediatric-specific quality standards and indicators. Using a rigorous guideline development process, the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN) was developed to support continuous quality improvement efforts within and across pediatric endoscopy services.Areas covered: This review presents a framework, informed by the PEnQuIN guidelines, for assessing endoscopist competence, granting procedural privileges, audit and feedback, and for skill remediation, when required. As is critical for promoting quality, PEnQuIN indicators can be benchmarked at the individual endoscopist, endoscopy facility, and endoscopy community levels. Furthermore, efforts to incorporate technologies, including electronic medical records and artificial intelligence, into endoscopic quality improvement processes can aid in creation of large-scale networks to facilitate comparison and standardization of quality indicator reporting across sites.Expert opinion: PEnQuIN quality standards and indicators provide a framework for continuous quality improvement in pediatric endoscopy, benefiting individual endoscopists, endoscopy facilities, and the broader endoscopy community. Routine and reliable measurement of data, facilitated by technology, is required to identify and drive improvements in care. Engaging all stakeholders in endoscopy quality improvement processes is crucial to enhancing patient outcomes and establishing best practices for safe, efficient, and effective pediatric endoscopic care.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"89-102"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140093715","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

Comparative effectiveness of warfarin in cirrhotic patients with non-symptomatic portal vein thrombosis: a multicenter, randomized controlled trial. 华法林对无症状门静脉血栓形成的肝硬化患者的疗效比较：一项多中心随机对照试验。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-01-29 DOI: 10.1080/17474124.2024.2307575

Shenxin Lu, Jie Chen, Rui Zhang, Tiancheng Luo, Lili Ma, Pengju Xu, Hong Ding, Xiaoqing Zeng, Bing Wu, Yihai Shi, Chenghai Liu, Yongping Mu, Shiyao Chen, Jian Wang

{"title":"Comparative effectiveness of warfarin in cirrhotic patients with non-symptomatic portal vein thrombosis: a multicenter, randomized controlled trial.","authors":"Shenxin Lu, Jie Chen, Rui Zhang, Tiancheng Luo, Lili Ma, Pengju Xu, Hong Ding, Xiaoqing Zeng, Bing Wu, Yihai Shi, Chenghai Liu, Yongping Mu, Shiyao Chen, Jian Wang","doi":"10.1080/17474124.2024.2307575","DOIUrl":"10.1080/17474124.2024.2307575","url":null,"abstract":"The effectiveness and risks of anticoagulant therapy in cirrhotic patients with non-symptomatic portal vein thrombosis (PVT) remain unclear. We conducted a multicenter, Zelen-designed randomized controlled trial to determine the effectiveness of warfarin in cirrhotic patients with non-symptomatic PVT during a one-year follow-up. In brief, 64 patients were 1:1 randomly divided into the anticoagulation group or the untreated group. The probability of recanalization was significantly higher in the anticoagulation group than those untreated in both ITT analysis (71.9% vs 34.4%, p = 0.004) and PP analysis (76.7% vs 32.4%, p < 0.001). Anticoagulation treatment was the independent predictor of recanalization (HR 2.776, 95%CI 1.307-5.893, p = 0.008). The risk of bleeding events and mortality were not significantly different. A significantly higher incidence of ascites aggravation was observed in the untreated group (3.3% vs 26.5%, p = 0.015). In conclusion, warfarin was proved to be an effective and safe as an anticoagulation therapy for treating non-symptomatic PVT in cirrhotic patients.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"5-12"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491006","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