Expert Review of Gastroenterology & Hepatology最新文献_第8页

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

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

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

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

Implications of the microbiome after pancreatic cancer resection with regard to morbidity and mortality. 胰腺癌切除术后微生物组对发病率和死亡率的影响。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-11-01 Epub Date: 2024-11-25 DOI: 10.1080/17474124.2024.2427648

Nabeel Merali, Tarak Chouari, Su Junjun, Timothy A Rockall, Elisa Giovannetti, Nicola Annels, Adam E Frampton

引用次数: 0

Colonic diverticular disease revisited. 结肠憩室病复诊。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-11-01 Epub Date: 2024-12-19 DOI: 10.1080/17474124.2024.2438708

Arjuna Priyadarsin de Silva, Nilushi Nuwanshika, Uditha Dassanayake, Madunil Anuk Niriella, Poornima Ranasinghe, H Janaka de Silva

{"title":"Colonic diverticular disease revisited.","authors":"Arjuna Priyadarsin de Silva, Nilushi Nuwanshika, Uditha Dassanayake, Madunil Anuk Niriella, Poornima Ranasinghe, H Janaka de Silva","doi":"10.1080/17474124.2024.2438708","DOIUrl":"10.1080/17474124.2024.2438708","url":null,"abstract":"Introduction: Diverticular disease, including diverticulosis and diverticulitis, presents a significant health concern globally, with increasing prevalence in Western societies and emerging trends in Asia. The incidence of diverticulitis, is on the rise, leading to significant morbidity and healthcare costs.Areas covered: A literature search was conducted using the PubMed database, and studies published between 1995 and 2024 were selected based on their relevance to the overall understanding of disease. This review investigates the clinical spectrum, classification, and management strategies of diverticular disease, focusing particularly on evolving trends in diagnosis and treatment. Discussions regarding the prevalence of diverticulosis, the identification of risk factors associated with disease progression, recent advancements in research, and the utilization of biomarkers in disease monitoring and treatment decision-making are considered in detail.Expert opinion: The discourse on diverticular disease underscores the pressing need for tailored management strategies and innovative treatments. Understanding the intricacies of the disease's pathophysiology is paramount for effective intervention. Recent advances in diagnostic imaging and biomarker identification are promising, yet more research is imperative to further refine patient care. Advances in these areas hold the potential for significantly improving outcomes in disease management.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"745-752"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794440","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

Overcoming the effects of increasing antimicrobial resistance on Helicobacter pylori therapy. 克服耐药性增加对幽门螺杆菌治疗的影响。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-11-01 Epub Date: 2024-12-11 DOI: 10.1080/17474124.2024.2435520

David Yates Graham, Theodore Rokkas

{"title":"Overcoming the effects of increasing antimicrobial resistance on Helicobacter pylori therapy.","authors":"David Yates Graham, Theodore Rokkas","doi":"10.1080/17474124.2024.2435520","DOIUrl":"10.1080/17474124.2024.2435520","url":null,"abstract":"Introduction: Resistance to the antibiotics used to treat Helicobacter pylori (H. pylori) has risen to alarming levels worldwide emphasizing the need to reconsider the approach to therapy generally and to reconsider whether to continue use of many previously highly effective treatment regimens.Areas covered: This review covers current aspects management of the response to the effects of antimicrobial resistance on H. pylori therapy.Expert opinion: The prevalence of antimicrobial resistance to H. pylori is increasing and must now be integrated into management of the infection. Bacterial factors responsible for resistance include mutations, efflux pumps, and biofilm formation. Societal factors include overuse and misuse of antibiotics, including in the therapy of H. pylori infections. H. pylori infections should be managed as an infectious disease based on the principles of antimicrobial stewardship which should be incorporated into ongoing community-based and hospital programs of antibiotic stewardship to provide up-to-date advice regarding susceptibility and locally optimized best treatment practices (i.e. advice on which drugs, doses, formulation, frequency of administration, etc. The infection would best be managed in concert with infectious disease especially in asymptomatic patients. Gastroenterology's input remains critical for management of complications of the infection such as peptic ulcer disease.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"705-711"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806597","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

Gastroesophageal reflux disease: indications for antireflux surgery, outcomes, and side effects. 胃食管反流病：抗反流手术的适应症、结果和副作用

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-11-01 Epub Date: 2024-12-10 DOI: 10.1080/17474124.2024.2438719

Francisco Schlottmann, Sofia Bertona, Fernando A M Herbella, Marco G Patti

{"title":"Gastroesophageal reflux disease: indications for antireflux surgery, outcomes, and side effects.","authors":"Francisco Schlottmann, Sofia Bertona, Fernando A M Herbella, Marco G Patti","doi":"10.1080/17474124.2024.2438719","DOIUrl":"10.1080/17474124.2024.2438719","url":null,"abstract":"Introduction: Gastroesophageal reflux disease (GERD) is a frequent digestive disorder that presents with a broad spectrum of symptoms. Global consensus on which patients should be selected for anti-reflux surgery is lacking.Areas covered: This evidence-based review will analyze current indications for anti-reflux surgery, outcomes of the operation, and potential side effects.Expert commentary: Treatment of GERD has three main purposes: control symptoms, improve quality of life, and prevent potential serious complications such as bleeding, esophageal stenosis, Barrett's esophagus, and esophageal adenocarcinoma. Although medical therapy is effective in the majority of patients, some might require anti-reflux surgery in order to achieve these goals. Adequate patient selection for anti-reflux surgery is critical to obtain optimal outcomes. Most patients undergoing a fundoplication have adequate long-term symptomatic relief. However, potential side effects of anti-reflux surgery should also be discussed with patients to help manage expectations from the operation.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"693-703"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779075","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