Expert Review of Gastroenterology & Hepatology最新文献_第9页

Impact of peptic ulcer bleeding on the in-hospital outcomes of cirrhotic patients with acute gastrointestinal bleeding: an international multicenter study. 消化性溃疡出血对急性消化道出血肝硬化患者院内预后的影响：一项国际多中心研究。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-08-01 Epub Date: 2024-08-12 DOI: 10.1080/17474124.2024.2387823

Yuhang Yin, Fanpu Ji, Fernando Gomes Romeiro, Mingyu Sun, Qiang Zhu, Dapeng Ma, Shanshan Yuan, Yingli He, Xiaofeng Liu, Cyriac Abby Philips, Nahum Méndez-Sánchez, Metin Basaranoglu, Kanokwan Pinyopornpanish, Yiling Li, Yunhai Wu, Yu Chen, Ling Yang, Lichun Shao, Andrea Mancuso, Frank Tacke, Su Lin, Bimin Li, Lei Liu, Xingshun Qi

{"title":"Impact of peptic ulcer bleeding on the in-hospital outcomes of cirrhotic patients with acute gastrointestinal bleeding: an international multicenter study.","authors":"Yuhang Yin, Fanpu Ji, Fernando Gomes Romeiro, Mingyu Sun, Qiang Zhu, Dapeng Ma, Shanshan Yuan, Yingli He, Xiaofeng Liu, Cyriac Abby Philips, Nahum Méndez-Sánchez, Metin Basaranoglu, Kanokwan Pinyopornpanish, Yiling Li, Yunhai Wu, Yu Chen, Ling Yang, Lichun Shao, Andrea Mancuso, Frank Tacke, Su Lin, Bimin Li, Lei Liu, Xingshun Qi","doi":"10.1080/17474124.2024.2387823","DOIUrl":"10.1080/17474124.2024.2387823","url":null,"abstract":"Objectives: Peptic ulcer is the most common source of non-variceal bleeding. However, it remains controversial whether the outcomes of cirrhotic patients with peptic ulcer bleeding differ from those with variceal bleeding.Methods: Cirrhotic patients with acute gastrointestinal bleeding (AGIB) who underwent endoscopy and had an identifiable source of bleeding were retrospectively screened from an international multicenter cohort. Logistic regression analyses were performed to explore the impact of peptic ulcer bleeding on in-hospital death and 5-day failure to control bleeding. Propensity score matching (PSM) analysis was performed by matching age, gender, Child-Pugh score, and model for end-stage liver disease score between the peptic ulcer bleeding and variceal bleeding groups.Results: Overall, 1535 patients were included, of whom 73 (4.7%) had peptic ulcer bleeding. Multivariate logistic regression analyses showed that peptic ulcer bleeding was not independently associated with in-hospital death (OR = 2.169, p = 0.126) or 5-day failure to control bleeding (OR = 1.230, p = 0.680). PSM analyses demonstrated that both in-hospital mortality (9.7% vs. 6.3%, p = 0.376) and rate of 5-day failure to control bleeding (6.9% vs. 5.4%, p = 0.787) were not significantly different between the two groups.Conclusions: The impact of peptic ulcer bleeding on the in-hospital outcomes of cirrhotic patients is similar to that of variceal bleeding.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"473-483"},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888932","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

Characteristic endoscopic findings in Helicobacter pylori diagnosis in clinical practice. 临床实践中幽门螺旋杆菌诊断的特征性内窥镜检查结果。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-08-01 Epub Date: 2024-08-22 DOI: 10.1080/17474124.2024.2395317

Mitsushige Sugimoto, Masaki Murata, Kazunari Murakami, Yoshio Yamaoka, Takashi Kawai

{"title":"Characteristic endoscopic findings in Helicobacter pylori diagnosis in clinical practice.","authors":"Mitsushige Sugimoto, Masaki Murata, Kazunari Murakami, Yoshio Yamaoka, Takashi Kawai","doi":"10.1080/17474124.2024.2395317","DOIUrl":"10.1080/17474124.2024.2395317","url":null,"abstract":"Introduction: Helicobacter pylori is a major risk factor for gastric cancer. In addition to eradication therapy, early-phase detection of gastric cancer through screening programs using high-vision endoscopy is also widely known to reduce mortality. Although European and US guidelines recommend evaluation of atrophy and intestinal metaplasia by high-vision endoscopy and pathological findings, the guideline used in Japan - the Kyoto classification of gastritis - is based on endoscopic evaluation, and recommends the grading of risk factors. This system requires classification into three endoscopic groups: H. pylori-negative, previous H. pylori infection (inactive gastritis), and current H. pylori infection (active gastritis). Major endoscopic findings in active gastritis are diffuse redness, enlarged folds, nodularity, mucosal swelling, and sticky mucus, while those in H pylori-related gastritis - irrespective of active or inactive status - are atrophy, intestinal metaplasia, and xanthoma.Areas covered: This review describes the endoscopic characteristics of current H. pylori infection, and how characteristic endoscopic findings should be evaluated.Expert opinion: Although the correct evaluation of endoscopic findings related to H. pylori remains necessary, if findings of possible infection are observed, it is important to diagnose infection by detection methods with high sensitivity and specificity, including the stool antigen test and urea breath test.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"457-472"},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003930","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

Practical management of mild-to-moderate ulcerative colitis: an international expert consensus. 轻度至中度溃疡性结肠炎的实用管理：国际专家共识。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-08-01 Epub Date: 2024-09-03 DOI: 10.1080/17474124.2024.2397650

Ferdinando D'Amico, Fernando Magro, Axel Dignass, Sameer Al Awadhi, Ana Gutierrez Casbas, Natália Sousa Freitas Queiroz, Grażyna Rydzewska, Byong Duk Ye, Zhihua Ran, Ailsa Hart, Vipul Jairath, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese

{"title":"Practical management of mild-to-moderate ulcerative colitis: an international expert consensus.","authors":"Ferdinando D'Amico, Fernando Magro, Axel Dignass, Sameer Al Awadhi, Ana Gutierrez Casbas, Natália Sousa Freitas Queiroz, Grażyna Rydzewska, Byong Duk Ye, Zhihua Ran, Ailsa Hart, Vipul Jairath, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese","doi":"10.1080/17474124.2024.2397650","DOIUrl":"10.1080/17474124.2024.2397650","url":null,"abstract":"Introduction: Although there are well-defined guidelines for the management of mild-to-moderate ulcerative colitis (UC), there are still unmet needs. For this reason, we conducted an international expert consensus to standardize the management of patients with mild-to-moderate UC and provide practical guidance to clinicians.Areas covered: Based on Delphi methodology, 15 statements were approved after two rounds of voting, addressing several aspects of disease management from sequencing to treatment duration, from monitoring to optimization techniques and safety profile.Expert opinion: Growing knowledge of mild-to-moderate UC has led to the development of new ambitious outcomes such as histological remission and disease clearance. Furthermore, noninvasive tools for patient monitoring such as fecal calprotectin and intestinal ultrasound are now available. Their implementation in clinical practice will allow clinicians to tightly monitor disease activity and promptly adapt treatment, avoiding complications and disease progression and targeting better disease control.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"421-430"},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119278","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 sleeve gastroplasty for metabolic dysfunction-associated steatotic liver disease. 内镜袖状胃成形术治疗代谢功能障碍相关性脂肪肝。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-08-01 Epub Date: 2024-09-05 DOI: 10.1080/17474124.2024.2387231

Maria Valeria Matteo, Loredana Gualtieri, Vincenzo Bove, Giulia Palumbo, Valerio Pontecorvi, Martina De Siena, Federico Barbaro, Cristiano Spada, Ivo Boškoski

{"title":"Endoscopic sleeve gastroplasty for metabolic dysfunction-associated steatotic liver disease.","authors":"Maria Valeria Matteo, Loredana Gualtieri, Vincenzo Bove, Giulia Palumbo, Valerio Pontecorvi, Martina De Siena, Federico Barbaro, Cristiano Spada, Ivo Boškoski","doi":"10.1080/17474124.2024.2387231","DOIUrl":"10.1080/17474124.2024.2387231","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly nonalcoholic fatty liver disease - NAFLD) is a chronic liver condition linked to obesity and metabolic syndrome. It affects one-third of people globally and, in some cases, can lead to metabolic dysfunction-associated steatohepatitis (MASH, formerly nonalcoholic steatohepatitis, NASH) and fibrosis. Weight loss is crucial for the treatment of MASLD, but diet and lifestyle modifications often fail.Areas covered: In recent years, endoscopic sleeve gastroplasty (ESG) has gained popularity as an effective and minimally invasive option for obesity treatment, with widespread use worldwide. We present a current overview of the most significant studies conducted on ESG for the management of obesity and MASLD. Our report includes data from published studies that have evaluated the impact of ESG on noninvasive hepatic parameters used to estimate steatosis and fibrosis. However, at present, there are no data available on liver histology.Expert opinion: ESG has shown promising results in treating MASLD evaluated by noninvasive tests, but current data is limited to small, nonrandomized studies. More research is needed, particularly on the effects of ESG on histologically proven MASH. If future research confirms its efficacy, ESG may be incorporated into treatment guidelines in the future.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"397-405"},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132267","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

Metabolic dysfunction-associated steatotic liver disease and diabetes: the cross-talk between hepatologist and diabetologist. 代谢功能障碍相关性脂肪性肝病与糖尿病：肝病学家与糖尿病学家之间的对话。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-08-01 Epub Date: 2024-08-08 DOI: 10.1080/17474124.2024.2388790

Ming-Lun Yeh, Jee-Fu Huang, Chia-Yen Dai, Chung-Feng Huang, Ming-Lung Yu, Wan-Long Chuang

{"title":"Metabolic dysfunction-associated steatotic liver disease and diabetes: the cross-talk between hepatologist and diabetologist.","authors":"Ming-Lun Yeh, Jee-Fu Huang, Chia-Yen Dai, Chung-Feng Huang, Ming-Lung Yu, Wan-Long Chuang","doi":"10.1080/17474124.2024.2388790","DOIUrl":"10.1080/17474124.2024.2388790","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (DM) are the most prevalent metabolic disorders globally. The numbers affected in both disorders are also rapidly increasing with alarming trends in children and young adults.Areas covered: Insulin resistance (IR) and the subsequent metabolic dysregulation are the fundamental pathogenesis pathways of the prevalent metabolic disorders. The interaction and impacts are bidirectional between MASLD and DM in terms of disease mechanisms, disease course, risks, and prognosis. There's a pressing issue for highlighting the links between MASLD and DM for both care specialists and primary care providers. The review collected the scientific evidence addressing the mutual interactions between the two disorders. The strategies for surveillance, risk stratification, and management are discussed in a practical manner. It also provides individualized viewpoints of patient care in hepatology and diabetology.Expert opinion: Both MASLD and DM shared similar disease mechanisms, and affected the disease development and progression in a bidirectional manner. The high prevalence and the cross-link between the two disorders raise clinical issues from awareness, screening, risk stratification, optimal referral, to appropriate management for primary care providers.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"431-439"},"PeriodicalIF":3.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888933","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

Symptomatic uncomplicated diverticular disease: a critical appraisal. 无症状无并发症憩室疾病：一项重要评估。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-08-05 DOI: 10.1080/17474124.2024.2388797

Camilla Ritieni, Caterina Sbarigia, Silvia Scalamonti, Bruno Annibale, Marilia Carabotti

{"title":"Symptomatic uncomplicated diverticular disease: a critical appraisal.","authors":"Camilla Ritieni, Caterina Sbarigia, Silvia Scalamonti, Bruno Annibale, Marilia Carabotti","doi":"10.1080/17474124.2024.2388797","DOIUrl":"10.1080/17474124.2024.2388797","url":null,"abstract":"Introduction: Symptomatic uncomplicated diverticular disease (SUDD) is a clinical condition included in the spectrum of symptomatic diverticular disease. The symptom profile associated with SUDD is highly heterogeneous, as there are currently discordant definitions, that encompass many clinical scenarios.Areas covered: We conducted a narrative review to assess the symptom profile and diagnostic criteria of SUDD based on the available evidence. A thorough literature search was performed on PubMed following the SANRA scale. Abdominal pain, regardless of its duration and location, emerges as the cardinal symptom of SUDD, suggesting that it should be central to its diagnosis. Although abdominal bloating and changes in bowel habits are commonly reported, they do not appear to be specifically attributable to SUDD. Other issues considered are the possible overlap with irritable bowel syndrome and the identification of a subcategory of SUDD patients with chronic symptoms following an episode of acute diverticulitis.Expert opinion: The future agenda should include the development of shared diagnostic criteria for SUDD, including well-defined inclusion and exclusion clinical features and symptom patterns.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"315-323"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874567","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

Gastroparesis treatment options metoclopramide and prucalopride: analysis of the FDA Adverse Event Reporting System (FAERS) database. 胃痉挛治疗方案甲氧氯普胺和普鲁卡必利：FDA 不良事件报告系统 (FAERS) 数据库分析。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-07-15 DOI: 10.1080/17474124.2024.2380315

Michael B Andrews, Douglas G Adler

{"title":"Gastroparesis treatment options metoclopramide and prucalopride: analysis of the FDA Adverse Event Reporting System (FAERS) database.","authors":"Michael B Andrews, Douglas G Adler","doi":"10.1080/17474124.2024.2380315","DOIUrl":"10.1080/17474124.2024.2380315","url":null,"abstract":"Background: We aimed to examine the common adverse drug reactions (ADRs) of metoclopramide, FDA-approved for treating many gastrointestinal conditions including gastroparesis, and prucalopride, FDA-approved for treating chronic idiopathic constipation but used off-label for other gastrointestinal conditions including gastroparesis.Research design and methods: The FDA Adverse Event Reporting System (FAERS) was analyzed from January 2013 to December 2023. ADR reports regarding use of only metoclopramide or prucalopride were analyzed following exclusion of reports indicating use for treatment of non-gastrointestinal conditions.Results: Analysis of 1,085 reports on metoclopramide revealed tardive dyskinesia (n = 393, 36.2%) and dystonia (n = 170, 15.7%) among the most reported ADRs in addition to QTc prolongation (n = 16, 1.5%) with progression to Torsade de pointes (n = 5, 0.5%) and triggering of pheochromocytoma crisis (n = 24, 2.2%). Analysis of 865 reports on prucalopride revealed headache (n = 120, 13.9%), diarrhea (n = 116, 13.4%), and abdominal pain (n = 100, 11.6%) as the most common ADRs with 22 reports (2.5%) of dystonia with the use of prucalopride.Conclusions: This FAERS database analysis shows post-marketing reports of ADRs from metoclopramide most frequently include tardive dyskinesia, dystonia, and tremor in addition to potentially fatal arrhythmias such as Torsade de pointes. Consumers of prucalopride may also be at risk of dystonia and other ADRs.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"389-395"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590052","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 updates on treatment options for primary follicular lymphoma of the gastrointestinal tract. 胃肠道原发性滤泡性淋巴瘤治疗方案的最新进展。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-07-01 Epub Date: 2024-07-15 DOI: 10.1080/17474124.2024.2380337

Masaya Iwamuro, Takehiro Tanaka, Daisuke Ennishi, Motoyuki Otsuka

{"title":"Recent updates on treatment options for primary follicular lymphoma of the gastrointestinal tract.","authors":"Masaya Iwamuro, Takehiro Tanaka, Daisuke Ennishi, Motoyuki Otsuka","doi":"10.1080/17474124.2024.2380337","DOIUrl":"10.1080/17474124.2024.2380337","url":null,"abstract":"Background: Primary gastrointestinal follicular lymphoma is a subtype of follicular lymphoma that originates directly from the gastrointestinal tract. Pathologically, it exhibits substantial similarities with the secondary gastrointestinal involvement observed in nodal follicular lymphoma. However, primary gastrointestinal follicular lymphoma presents clinically distinct features, necessitating divergent considerations in treatment selection compared with nodal follicular lymphoma.Areas covered: This narrative review focused on recent articles (2018-2023) regarding the long-term prognosis and treatment options for gastrointestinal follicular lymphoma. In addition, a brief overview of gastrointestinal follicular lymphomas is provided.Expert opinion: Patients with primary gastrointestinal follicular lymphoma often present with a low tumor burden. Lymphoma lesions typically remain asymptomatic for several years or may undergo spontaneous regression without immediate treatment. Therefore, a 'watch and wait' approach is justified. Conversely, when large tumor masses are identified in the gastrointestinal tract, the potential for tumor bleeding or intestinal obstruction requires timely therapeutic interventions.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"367-375"},"PeriodicalIF":3.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598913","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

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