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

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

An update on improving long-term outcomes for patients with chronic pancreatitis post-surgery. 改善慢性胰腺炎患者术后长期疗效的最新进展。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-02-27 DOI: 10.1080/17474124.2024.2321947

Alberto Zorzi, Pietro Campagnola, Antonio Amodio, Federico Caldart, Nicolo De Pretis, Luca Frulloni

{"title":"An update on improving long-term outcomes for patients with chronic pancreatitis post-surgery.","authors":"Alberto Zorzi, Pietro Campagnola, Antonio Amodio, Federico Caldart, Nicolo De Pretis, Luca Frulloni","doi":"10.1080/17474124.2024.2321947","DOIUrl":"10.1080/17474124.2024.2321947","url":null,"abstract":"Introduction: Chronic pancreatitis is a common inflammatory disease that severely impairs patients' quality of life, mainly due to abdominal pain which is the most frequent symptom. Current guidelines suggest medical therapy as the first line intervention based on a stepwise use of analgesics (i.e. NSAIDs followed by weak opioids and later by strong oppioids), which is rarely effective in improving pain and often leads to opioid addiction. Interventional procedures are therefore frequently needed. Endoscopic therapy is suggested as the second line of intervention, aiming at decompressing the main pancreatic duct via structure dilatation and ductal stone removal. Endoscopic therapy is usually effective in reducing pain in the short term, but its effects frequently decrease with time and multiple procedures are often required. Surgery is usually reserved as a last resource when medical and endoscopic therapy have failed. Pancreatic surgery is burdened with non negligible morbidity and mortality but is effective in reducing pain and improving quality of life in chronic pancratitis with long lasting effects.Areas covered: Surgical treatment of chronic pancreatitis is based on resection of inflammatory head mass or decompression of the ductal system, alone or in combination, which can be performed using different techniques. In this paper we reviewed the current evidence on the long-term outcomes of this type of surgery in terms of pain relief, quality of life, exocrine end endocrine function, and long-term mortality.Expert opinion: Quality of current evidence on this field is on average poor; a consensus to define clinically significant outcomes is needed in order to correctly design prospective studies that will enable gastroenterologists to understand which patients, and when, will benefit most from surgery and should therefore be referred to surgeons.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"25-36"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905374","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

Towards holistic integrative medicine based management strategy of liver cirrhosis. 以整体综合医学为基础的肝硬化管理策略。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-03-07 DOI: 10.1080/17474124.2024.2328211

Deli Zou, Zhiping Yang, Xingshun Qi, Daiming Fan

引用次数: 0

Influence of metabolic dysfunction-associated fatty liver disease on the prognosis of patients with HBV-related acute-on-chronic liver failure. 代谢功能障碍相关脂肪肝对 HBV 相关急性-慢性肝衰竭患者预后的影响。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI: 10.1080/17474124.2023.2298261

Rui-Min Lai, Li-Xi Yao, Shan Lin, Jia-Hui Zhou, Bing-Ping Liu, Zhao-Yi Liang, Tianbin Chen, Jia-Ji Jiang, Qi Zheng, Yueyong Zhu

{"title":"Influence of metabolic dysfunction-associated fatty liver disease on the prognosis of patients with HBV-related acute-on-chronic liver failure.","authors":"Rui-Min Lai, Li-Xi Yao, Shan Lin, Jia-Hui Zhou, Bing-Ping Liu, Zhao-Yi Liang, Tianbin Chen, Jia-Ji Jiang, Qi Zheng, Yueyong Zhu","doi":"10.1080/17474124.2023.2298261","DOIUrl":"10.1080/17474124.2023.2298261","url":null,"abstract":"Objectives: Metabolic-associated fatty liver disease (MAFLD) has clinical relevance in patients with acute-on-chronic liver failure (ACLF). We investigated the association between MAFLD and prognosis in patients with ACLF.Methods: We included patients with ACLF with available clinical data who visited our hospital for nearly 9 years. We compared the prognosis of patients in the different subgroups of ACLF and predicted the incidence of adverse outcomes. Moreover, a new model based on MAFLD was established.Results: Among 339 participants, 75 had MAFLD. The prognosis of patients with ACLF was significantly correlated with MAFLD. Patients with ACLF with concomitant MAFLD tended to have a lower cumulative survival rate (p = 0.026) and a higher incidence of hepatorenal syndrome (9.33% versus 3.40%, p = 0.033) than those without MAFLD. We developed an TIM2 model and the area under the ROC curve of the new model for 30-day and 60-day mortality (0.759 and 0.748) was higher than other predictive methods.Conclusion: The presence of MAFLD in patients with HBV-related ACLF was associated with an increased risk of in-hospital mortality. Moreover, The TIM2 model is a high-performance prognostic score for HBV-related ACLF.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"103-112"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073816","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

Histologic assessments in ulcerative colitis: the evidence behind a new endpoint in clinical trials. 溃疡性结肠炎的组织学评估：临床试验新终点背后的证据。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-01-01 Epub Date: 2024-03-21 DOI: 10.1080/17474124.2024.2326838

Rish K Pai, Geert D'Haens, Taku Kobayashi, Bruce E Sands, Simon Travis, Vipul Jairath, Gert De Hertogh, Bomina Park, Kim McGinnis, Isabel Redondo, Nicole G Lipitz, Theresa Hunter Gibble, Fernando Magro

{"title":"Histologic assessments in ulcerative colitis: the evidence behind a new endpoint in clinical trials.","authors":"Rish K Pai, Geert D'Haens, Taku Kobayashi, Bruce E Sands, Simon Travis, Vipul Jairath, Gert De Hertogh, Bomina Park, Kim McGinnis, Isabel Redondo, Nicole G Lipitz, Theresa Hunter Gibble, Fernando Magro","doi":"10.1080/17474124.2024.2326838","DOIUrl":"10.1080/17474124.2024.2326838","url":null,"abstract":"Introduction: Treatment goals for ulcerative colitis (UC) are evolving from the achievement of clinical remission to more rigorous goals defined by endoscopic and histologic healing. Achievement of deeper remission targets aims to reduce the risk of colectomy, hospitalizations, and colorectal cancer.Areas covered: This review covers histologic assessments, histologic remission as a clinical trial endpoint, and the association between histologic disease activity and clinical outcomes. Future directions are also discussed, including the use of advanced imaging and artificial intelligence technologies, as well as potential future treatment targets beyond histologic remission.Expert opinion: Histologic assessments are used for their sensitivity in measuring mucosal inflammatory changes in UC. Due to correlation with disease activity, histologic assessments may support clinical decision-making regarding treatment decisions as such assessments can be associated with rates of clinical relapse, hospitalization, colectomy, and neoplasia. While histologic remission is limited by varying definitions and multiple histologic indices, work is ongoing to create a consensus on the use of histologic assessments in clinical trials. As research advances, aspirational targets beyond histologic remission, such as molecular healing and disease clearance, are being explored.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":"18 1-3","pages":"73-87"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174131","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

Managing complications of chronic pancreatitis: a guide for the gastroenterologist 处理慢性胰腺炎并发症：消化内科医生指南

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-14 DOI: 10.1080/17474124.2023.2295498

Gabriele Capurso, Matteo Tacelli, Giuseppe Vanella, Ruggero Ponz de Leon Pisani, Giuseppe Dell’anna, Martina Abati, Roberto Mele, Gaetano Lauri, Afrodita Panaitescu, Rubino Nunziata, Piera Zaccari, Livia Archibugi, Paolo Giorgio Arcidiacono

引用次数: 0

Risankizumab to treat moderately to severely active Crohn’s disease in adults: an evaluation of trials and data 利桑珠单抗治疗成人中度至重度活动性克罗恩病：试验和数据评估

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-14 DOI: 10.1080/17474124.2023.2295496

Amanda M. Johnson, Edward V. Loftus Jr.

引用次数: 0

Recent advances in the treatment of gastrointestinal motility disorders in children 治疗儿童胃肠道运动障碍的最新进展

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-14 DOI: 10.1080/17474124.2023.2295495

Andreia Florina Nita, Atchariya Chanpong, Kornilia Nikaki, Anna Rybak, Nikhil Thapar, Osvaldo Borrelli

引用次数: 0

Recent developments in diagnosing bile acid diarrhea 诊断胆汁酸腹泻的最新进展

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-12 DOI: 10.1080/17474124.2023.2293814

Camille Lupianez-Merly, Saam Dilmaghani, Michael Camilleri

引用次数: 0

Diagnosis and management of pancreatic insufficiency in patients with gastrectomy due to cancer or gastric ulcers: a virtual roundtable expert discussion. 癌症或胃溃疡导致胃切除术患者胰腺功能不全的诊断和管理：虚拟圆桌专家讨论。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2296762

Daniel Croagh, Christoph W Michalski, Mark I van Berge Henegouwen, Sergio Alfieri

{"title":"Diagnosis and management of pancreatic insufficiency in patients with gastrectomy due to cancer or gastric ulcers: a virtual roundtable expert discussion.","authors":"Daniel Croagh, Christoph W Michalski, Mark I van Berge Henegouwen, Sergio Alfieri","doi":"10.1080/17474124.2023.2296762","DOIUrl":"10.1080/17474124.2023.2296762","url":null,"abstract":"Introduction: Pancreatic exocrine insufficiency (PEI) is common after gastric resection for cancer or ulcers but is under-recognized and undertreated. Although pancreatic enzyme replacement therapy (PERT) is the mainstay of PEI management, robust evidence supporting its use after gastric surgery is limited.Areas covered: In the absence of guideline recommendations specific for patients with pancreatic insufficiency after gastrectomy, a panel of experts from different geographical regions convened in a virtual meeting to discuss their approach to patient management.Expert opinion: Pancreatic insufficiency after gastrointestinal surgery is not a simple post-surgical complication as several factors contribute to its development. Although the pancreas is unimpaired after gastrectomy, it cannot function normally in the altered environment. Pancreatic insufficiency can be challenging to diagnose in gastrectomy patients due to nonspecific symptoms and the absence of a simple diagnostic test. Fecal elastase appears to be the default test, although it is not sufficiently sensitive nor reliable for diagnosing or monitoring PEI. Patients with maldigestion symptoms after gastrectomy are treated pragmatically: those with clinical suspicion of pancreatic insufficiency receive a trial of PERT and are monitored for symptom improvement. There is a clear need for high-quality evidence from clinical trials to guide the management of this patient population.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1313-1319"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802135","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