Gastroenterology Research最新文献

{"title":"Primary Squamous Cell Biliary Carcinoma With Liver Metastasis Is Rare but Malicious.","authors":"Mohamad Khaled Almujarkesh, Anirudh R Damughatla, Jasdeep Bathla, Kyle Sugg, Dana LaBuda, Samer Alkassis, Mohammed Najeeb Al Hallak","doi":"10.14740/gr1637","DOIUrl":"10.14740/gr1637","url":null,"abstract":"<p><p>Primary squamous cell carcinoma (SCC) of the liver is quite rare, and to our knowledge, very few cases have been reported in the literature. The exact pathogenesis of the disease is unestablished; however, it is mostly reported to be associated with hepatic cyst, Caroli's disease, hepatolithiasis, hepatic cirrhosis, and hepatic teratoma. We report a case of a 50-year-old woman with no prior medical history initially, who presented with postprandial epigastric and right upper quadrant pain that continued to worsen and was associated with early satiety, nausea, and weight loss of 25 pounds over 2 months, which prompted further evaluation by her primary care physician. Magnetic resonance imaging (MRI) examination a month later revealed a large heterogeneous area measuring 8.5 × 2.4 × 7.4 cm in the inferior right hepatic lobe with heterogeneous enhancement and involvement of the gallbladder, concerning for cholangiocarcinoma. Given radiographic findings, she underwent a computed tomography (CT)-guided core biopsy of the liver, which showed a necrotic malignant tumor favoring adenocarcinoma and was also found to have germline <i>BRCA</i> mutation. A positron emission tomography (PET) scan revealed a large partially necrotic fluorodeoxyglucose (FDG) avid mass, possibly arising from the gallbladder fossa with an invasion of both lobes of the liver and probable involvement of a portion of the ascending colon. There was no gross evidence of distant metastatic disease. The patient underwent staging laparoscopy prior to initiating chemotherapy, and another biopsy was done, which returned in favor of SCC, with immunohistochemical stains being positive for cytokeratin (CK)19, Ber-EP4 (epithelial antigen recognized by Ber-EP4 antibody), and P40 (DeltaNp63); while negative for CK7, CK20, caudal-type homeobox 2 (CDX-2), paired box 8 (PAX-8), and mucicarmine. The patient started platinum-based chemotherapy due to germline <i>BRCA</i> mutation. However, due to complications associated with therapy and the progression of the disease, the patient eventually chose hospice. Primary SSC remains an unexplored aggressive malignancy that carries an overall poor prognosis. Diagnosis can be challenging and requires high clinical suspicion due to the scarcity in specific laboratory workup. Pathological diagnosis remains the gold standard; however, it also carries its own challenges. Treatment is usually case-oriented, and definitive protocols have yet to be established.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 5","pages":"276-279"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71480106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Significant Effect of Pemafibrate on Hepatic Steatosis and Fibrosis Indexes in Patients With Hypertriglyceridemia.","authors":"Hisayuki Katsuyama, Hidekatsu Yanai, Hiroki Adachi, Mariko Hakoshima","doi":"10.14740/gr1656","DOIUrl":"10.14740/gr1656","url":null,"abstract":"<p><strong>Background: </strong>We previously reported that the selective peroxisome proliferator-activated receptor alpha modulator, pemafibrate, significantly reduced serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) and significantly increased serum albumin levels at 3, 6 and 12 months after the start of pemafibrate, with an improvement of atherogenic dyslipidemia, in patients with hypertriglyceridemia.</p><p><strong>Methods: </strong>We performed a <i>post hoc</i> analysis of our previous data obtained from patients with hypertriglyceridemia who had been prescribed pemafibrate continuously for 1 year or longer. We compared the indexes for hepatic steatosis (hepatic steatosis index (HSI)) and fibrosis (nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS), AST to platelet ratio index (APRI) and FIB-4 index) at baseline with the data at 1 year after the start of pemafibrate.</p><p><strong>Results: </strong>Pemafibrate significantly reduced HSI at 1 year after the start of pemafibrate. NFS did not show a significant change after 1 year. However, APRI was significantly reduced by pemafibrate after 1 year. FIB-4 index significantly decreased in patients with baseline FIB-4 index ≥ 1.45 at 1 year after the start of pemafibrate. HSI at baseline tended to be negatively correlated with change in HSI after 1 year. There was no significant correlation between NFS at baseline and change in this score after 1 year. APRI and FIB-4 index at baseline were significantly and negatively correlated with changes in APRI and FIB-4 index at 1 year after the start of pemafibrate.</p><p><strong>Conclusions: </strong>The 1-year pemafibrate treatment improved hepatic steatosis and fibrosis indexes in patients with hypertriglyceridemia.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"240-243"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/1b/gr-16-240.PMC10482606.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Colorectal Cancer Mortality in the United States, 1999 - 2020.","authors":"Alexander Kusnik,&nbsp;Sarath Lal Mannumbeth Renjithlal,&nbsp;Ari Chodos,&nbsp;Sanjana Chetana Shanmukhappa,&nbsp;Mohamed Magdi Eid,&nbsp;Keerthi Mannumbeth Renjith,&nbsp;Richard Alweis","doi":"10.14740/gr1631","DOIUrl":"https://doi.org/10.14740/gr1631","url":null,"abstract":"<p><strong>Background: </strong>The United States faces a significant public health issue with colorectal cancer (CRC), which remains the third leading cause of cancer-related fatalities despite early diagnosis and treatment progress.</p><p><strong>Methods: </strong>This investigation utilized death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER) database to investigate trends in CRC mortality and location of death from 1999 to 2020. Additionally, the study utilized the annual percent change (APC) to estimate the average annual rate of change over the specific time period for the given health outcome. Incorporating the location of death in this study served the purpose of identifying patterns related to CRC and offering valuable insights into the specific locations where deaths occurred.</p><p><strong>Results: </strong>Between 1999 and 2020, there were 1,166,158 CRC-related deaths. The age-adjusted mortality rates (AAMRs) for CRC consistently declined from 20.7 in 1999 to 12.5 in 2020. Men had higher AAMR (18.8) than women (13.4) throughout the study. Black or African American patients had the highest AAMR (21.1), followed by White (15.4), Hispanic/Latino (11.8), American Indian or Alaska native (11.4), and Asian or Pacific Islanders (10.2). The location of death varied, with 41.99% at home, 28.16% in medical facilities, 16.6% in nursing homes/long-term care facilities, 7.43% in hospices, and 5.80% at other/unknown places.</p><p><strong>Conclusion: </strong>There has been an overall improvement in AAMR among most ethnic groups, but an increase in AAMR has been observed among white individuals below the age of 55. Notably, over one-quarter of CRC-related deaths occur in medical facilities.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"217-225"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/77/gr-16-217.PMC10482602.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Clostridioides difficile</i> Infection in COVID-19 Hospitalized Patients: A Nationwide Analysis.","authors":"Xheni Deda,&nbsp;Khaled Elfert,&nbsp;Mustafa Gandhi,&nbsp;Alexander Malik,&nbsp;Esraa Elromisy,&nbsp;Nehemias Guevara,&nbsp;Suresh Nayudu,&nbsp;Matthew Bechtold","doi":"10.14740/gr1639","DOIUrl":"https://doi.org/10.14740/gr1639","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) is a significant healthcare-associated infection with implications for patient morbidity, mortality, and healthcare costs. However, the connection between CDI and coronavirus disease 2019 (COVID-19) infection and its influence on patient outcomes remain uncertain. This study aimed to examine the association between CDI and COVID-19, specifically investigating whether CDI worsens outcomes in patients with COVID-19. By utilizing the extensive National Inpatient Sample (NIS) database and analyzing pertinent factors, this research endeavored to enhance our understanding of CDI within the context of COVID-19.</p><p><strong>Methods: </strong>The NIS database was searched for adult patients hospitalized with a primary diagnosis of COVID-19 infection in 2020. Patients with a secondary diagnosis of CDI were identified and separated into two groups based on CDI status. Baseline characteristics, Charlson Comorbidity Index (CCI), and outcomes were compared between the two groups using Chi-square and <i>t</i>-tests. Multivariate logistic and linear regressions were performed for the identification of independent predictors of CDI and mortality.</p><p><strong>Results: </strong>A total of 1,045,125 COVID-19 hospitalizations were included, of which 4,920 had a secondary diagnosis of CDI. Patients with CDI and COVID-19 were older (mean age 69.9 vs. 64.2 years; P < 0.001), more likely to be female (54.1% vs. 47.1%; P < 0.001) and white (60% vs. 52.4%; P < 0.001). The CDI and COVID-19 group had a longer length of stay (14.1 vs. 7.42 days; P < 0.001), higher total hospital costs ($42,336 vs. $18,974; P < 0.001), and higher inpatient mortality (21.6% vs. 11%; P < 0.001) compared to the COVID-19 group without CDI. Patients in the CDI and COVID-19 group had a higher CCI score (51.7% with a score of 3 or more vs. 27.7%; P < 0.001), indicating a higher comorbidity burden. Multivariate logistic regression analysis revealed CDI was independently associated with increased mortality (odds ratio (OR) 1.37; P = 0.001) and showed that the female gender and several pre-existing comorbidities were associated with a higher likelihood of CDI.</p><p><strong>Conclusion: </strong>CDI is independently associated with increased mortality in patients admitted with COVID-19 infection. Female gender and several pre-existing comorbidities are independent predictors of CDI in COVID-19 patients.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"234-239"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/2e/gr-16-234.PMC10482604.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coma With Hyperammonemia in a Patient With Kwashiorkor.","authors":"Thibault Vieille,&nbsp;Francois Feillet,&nbsp;Arnaud Wiedemann,&nbsp;Hadrien Winiszewski,&nbsp;Gael Piton","doi":"10.14740/gr1634","DOIUrl":"https://doi.org/10.14740/gr1634","url":null,"abstract":"<p><p>We describe a case of coma-related hyperammonemia in a woman presenting with severe edematous malnutrition (Kwashiorkor-like), without underlying hepatic disease. Our main hypothesis is that the patient developed a functional urea cycle disorder, due to the inability to synthesize N-acetylglutamate which is the activator of the first enzymes (carbamoyl phosphate synthetase) of urea cycle, in a context of severe deficiency of essential amino acids and of acetyl-CoA. Severe hyperammonemia is a medical emergency exposing to the risk of cerebral edema. Urgent treatment should interrupt protein intake, stimulate protein anabolism, and remove ammonia from the blood using renal replacement therapy and ammonia scavengers. Hyperammonemia should be searched in case of unexplained coma, even among patients without hepatic disorder, in particular among young patients. Hyperammonemia should also be searched among patients with severe protein-calorie malnutrition.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"244-248"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/5e/gr-16-244.PMC10482601.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex and Race Disparities in Hepatocellular Carcinoma Surveillance in Patients With Chronic Hepatitis B During COVID-19: A Single-Center Retrospective Review.","authors":"William S Reiche,&nbsp;Stephen Cooper,&nbsp;Christopher J Destache,&nbsp;Suhail Sidhu,&nbsp;Bryce Schutte,&nbsp;Darby Keirns,&nbsp;Elezabeth Mac,&nbsp;Ian Ng,&nbsp;Haitam Buaisha,&nbsp;Manasa Velagapudi","doi":"10.14740/gr1614","DOIUrl":"https://doi.org/10.14740/gr1614","url":null,"abstract":"<p><strong>Background: </strong>The management of patients with chronic hepatitis B (CHB) is complex and spans multiple medical specialties. As a result of this complexity, patients with CHB often do not receive adequate monitoring including hepatocellular carcinoma (HCC) surveillance with abdominal ultrasonography. Previous studies have identified multiple factors associated with decreased HCC surveillance. We aimed to identify the impact of race and sex on HCC surveillance in patients with CHB.</p><p><strong>Methods: </strong>We performed a single health system chart review between January 2018 and January 2022. Differences between sex and race were evaluated using the Chi-square test and Fisher's exact test, and continuous variables were analyzed using analysis of variance (ANOVA).</p><p><strong>Results: </strong>A total of 248 patient records between January 2018 and January 2022 were evaluated. In total 37% of females were adequately screened for HCC in any of the 6-month time frames compared to 26% of males. During the coronavirus disease 2019 (COVID-19) surge, surveillance rates were reduced in both men and women. During the first 6 months of the COVID-19 surge, there was a significant difference in screening between men and women (19% vs. 35%, P = 0.026). There was a decrease in HCC screening across all races during the COVID-19 surge; however, no significant difference when comparing races was found.</p><p><strong>Conclusion: </strong>Men received less HCC surveillance compared to women. These differences were more pronounced during the COVID-19 pandemic surge. Obtaining appropriate surveillance is important and retrospective evaluations can help us determine the presence of health-related social needs so that progress can be made toward achieving health equity.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"203-208"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/3a/gr-16-203.PMC10482603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of <i>Helicobacter pylori</i> Infection on the Prognosis of Chronic Atrophic Gastritis by Inducing the Macrophage Polarization.","authors":"Chun Na Zhao,&nbsp;Li Li Xiao,&nbsp;Ying Zhang","doi":"10.14740/gr1636","DOIUrl":"https://doi.org/10.14740/gr1636","url":null,"abstract":"<p><strong>Background: </strong>Recently, the effects of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection on the prognosis of chronic atrophic gastritis (CAG) are still unclear. The aim of our study was to discuss the role of <i>H. pylori</i> infection on the prognosis of CAG by inducing the M1/M2 macrophage polarization.</p><p><strong>Methods: </strong>A total of 180 subjects as control (group 1), CAG patients without <i>H. pylori</i> infection (group 2) and <i>H. pylori</i>-associated CAG patients (group 3) were respectively recruited for this cross-sectional investigation in Daqing Oilfield General Hospital from May 2019 to July 2020. Their serum samples were collected to determine the concentrations of pro-inflammatory and anti-inflammatory cytokines. Meanwhile, the gastric mucosa was excised to determine the related gene expressions on the M1/M2 macrophage polarization. Then the prognosis of CAG was evaluated according to the status of clinical manifestations and endoscopic examination after the follow-up.</p><p><strong>Results: </strong>Notably, it was proved that compared with the control group, the expressions and concentrations of pro-inflammatory cytokines (M1 macrophage: inducible nitric oxide synthase (iNOS), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and interleukin-6 (IL-6)) were significantly higher, while the anti-inflammatory cytokines (M2 macrophage: arginase-1 (Arg-1), IL-4 and IL-10) were apparently reduced in the group 2 and group 3 (P < 0.05). Moreover, more days were needed for the prognosis of CAG in group 3 than those in group 2, which was accompanied by higher expressions of pro-inflammatory and lower anti-inflammatory cytokines at the baseline (P < 0.05). Furthermore, negative correlations were shown between the concentrations of iNOS, TNF-α, IFN-γ and IL-6, and the prognosis of CAG (P < 0.05), while positive correlations were observed between the contents of IL-4 and IL-10, and prognosis of CAG (P < 0.05).</p><p><strong>Conclusion: </strong>These above results indicated that <i>H. pylori</i> infection-induced disorders of M1/M2 macrophage polarization could affect the prognosis of CAG.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"226-233"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/f3/gr-16-226.PMC10482605.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Microbiota Transplantation in Human Immunodeficiency Virus-Infected Patient Population: A Systematic Review and Meta-Analysis.","authors":"Adnan Malik, Muhammad Imran Malik","doi":"10.14740/gr1624","DOIUrl":"10.14740/gr1624","url":null,"abstract":"<p><strong>Background: </strong>Patients with human immunodeficiency virus (HIV) infection suffer from alterations in gut microbiota due to recurrent gastrointestinal infections and systemic inflammation. Fecal microbiota transplantation (FMT) appears to be a potential therapy; however, there are concerns about its safety. Likewise, no previous meta-analysis evaluated FMT efficacy in HIV-infected patients.</p><p><strong>Methods: </strong>We conducted a thorough electronic search on PubMed, Scopus, OVID, Web of Science, and Cochrane CENTRAL for clinical studies assessing the safety and efficacy of FMT in patients with HIV and gastrointestinal dysbiosis, where FMT was indicated to restore the disrupted microbiota.</p><p><strong>Results: </strong>FMT significantly restored the typical microbiome in patients with <i>Clostridium difficile</i> (<i>C. difficile</i>) and non-<i>C. difficile</i> and reduced the risk of gastrointestinal infections in HIV patients receiving antiretroviral therapy (odds ratio (OR) = 0.774, 95% confidence interval (CI): (0.62, 0.966)). Furthermore, adverse events, such as distention and bloating, associated with FMT were comparable between HIV and health controls (OR = 0.60, 95% CI: (0.07, 4.6)), with no statistical difference.</p><p><strong>Conclusions: </strong>Current evidence demonstrated that FMT is safe and effective in HIV patients suffering from alterations in gut microbiota. We recommend further multi-centric clinical studies to address the optimal transplant amount and source for FMT. To the best of our knowledge, this is the first meta-analysis to assess the safety and efficacy of FMT in patients with HIV.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 4","pages":"209-216"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/f4/gr-16-209.PMC10482600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10211667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenteric Infarction With Cerebral Thrombotic Relapses and Pulmonary Embolism Two and Four Months After COVID-19.","authors":"Henrique Jose Pereira de Godoy,&nbsp;Guilherme Marum Olmedo,&nbsp;Jose Maria Pereira de Godoy,&nbsp;Paulo Cesar Espada","doi":"10.14740/gr1525","DOIUrl":"https://doi.org/10.14740/gr1525","url":null,"abstract":"<p><p>The aim of the present study was to report different sites of thrombotic events during and after coronavirus disease 2019 (COVID-19) in a 49-year-old patient who had acute mesenteric infarction in acute phase, stroke 2 months after and pulmonary thromboembolism 4 months after infection by COVID-19. The obese, previously healthy patient experienced myalgia and headache with subfebrile peaks and was tested positive for COVID-19 with a fast polymerase chain reaction (PCR) assay. Ten days after the onset of symptoms, the patient was submitted to exploratory laparotomy, which revealed 20 cm of small intestine loop with signs of suffering and thickening of the wall approximately 120 cm from the ileocecal valve. Two months after the event, angiotomography was performed, revealing effacement of the sulci in the right parietal region and hypersignal of the right middle cerebral artery with stop in M1. Two months later (4 months after the mesenteric infarction), chest angiotomography revealed signs of acute pulmonary thromboembolism, with no typical image of pulmonary infarction. Despite all these complications in the postoperative period, the patient survived.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"192-194"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/eb/gr-16-192.PMC10284650.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of Upper Gastrointestinal Bleeding Mortality in the United States Before and During the COVID-19 Era: Estimates From the Centers for Disease Control WONDER Database.","authors":"Nooraldin Merza,&nbsp;Ahmed Taher Masoud,&nbsp;Zohaib Ahmed,&nbsp;Dushyant Singh Dahiya,&nbsp;Ali Nawras,&nbsp;Abdallah Kobeissy","doi":"10.14740/gr1626","DOIUrl":"10.14740/gr1626","url":null,"abstract":"<p><strong>Background: </strong>There have been reports of increased upper gastrointestinal bleeding (UGIB) in patients with coronavirus disease 2019 (COVID-19). Still, only a few studies have examined the mortality rate associated with UGIB in the United States before and during COVID-19. Hereby, we explored the trends of UGIB mortality in the United States before and during COVID-19. The study's objective was to investigate whether the COVID-19 pandemic significantly impacted UGIB mortality rates in the USA.</p><p><strong>Methods: </strong>The decedents with UGIB were included. Age-standardized mortality rates were estimated with the indirect method using the 2000 US Census as the standard population. We utilized the deidentified data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Linear regression analysis was performed to determine 2021 projected mortality rates based on trends between 2012 and 2019 to quantify the association of the pandemic with UGIB-related deaths.</p><p><strong>Results: </strong>The mortality rate increased from 3.3 per 100,000 to 4.3 per 100,000 among the population between 2012 and 2021. There was a significant increase in the overall mortality rate between each year and the following year from 2012 to 2019, ranging from 0.1 to 0.2 per 100,000, while the rise in the overall mortality rate between each year and 2021 ranges from 0.4 to 0.9 per 100,000.</p><p><strong>Conclusions: </strong>Our results showed that the mortality rate increased among the population between 2012and 2021, suggesting a possible influence of COVID-19 infection on the incidence and mortality of UGIB.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"165-170"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/ee/gr-16-165.PMC10284642.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}