GastroHep最新文献

{"title":"Management of Acute Pancreatitis: Conservative Treatment and Step-Up Invasive Approaches—Evidence-Based Guidance for Clinicians","authors":"Michail I. Giakoumakis, I. Gkionis, Anastasios I. Marinis, M. Flamourakis, K. Spiridakis, Eleni S. Tsagkataki, Eleni I. Kaloeidi, A. Strehle, Emmanouil N. Bachlitzanakis, M. Christodoulakis","doi":"10.1155/2022/2527696","DOIUrl":"https://doi.org/10.1155/2022/2527696","url":null,"abstract":"Although acute pancreatitis is one of the most common conditions that physicians face in daily practice, different approaches are still being followed. Given that in 20–30% of cases, acute pancreatitis progresses to the severe form with single- or multiorgan failure and is often associated with admission to the intensive care unit, proper management is important. This article is aimed at emphasizing the importance of proper conservative treatment of acute pancreatitis and at focusing on intervention criteria in case of complications, analyzing additionally the step-up endoscopic and surgical approaches. The most common mistakes in conservative treatment include inadequate initial fluid resuscitation, abuse in the administration of antibiotics, insufficient analgesia, avoidance of oral feeding, and inappropriate use of imaging techniques. Moreover, the timing and indications for endoscopic retrograde cholangiopancreatography and cholecystectomy are crucial. Furthermore, in case of unsatisfying response to conservative treatment, which mainly happens during necrotic pancreatitis, early intervention is not indicated and a minimally invasive approach must be adopted firstly, 4 weeks after the onset of the disease, and before any surgical intervention. Each medical procedure has specific indications and must be used in the appropriate occasion. As a result, clinical doctors must be familiar both with the intervention criteria and the indications of each method. The proper management of acute pancreatitis is essential and life-saving. That is valid both for the conservative treatment and for the invasive approaches.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"186 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91459650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Proton-Pump Inhibitor Is Not Associated with Adverse Clinical Outcomes in COVID-19 Patients: A Territory-Wide Cohort Study","authors":"T. Yip, F. Chan, G. Lui, V. Wong, H. Chan, S. Wong, J. Mak, S. Ng, D. S. Hui, G. Wong","doi":"10.1155/2022/8803862","DOIUrl":"https://doi.org/10.1155/2022/8803862","url":null,"abstract":"Background. Evidence regarding the use of proton-pump inhibitors (PPIs) in COVID-19 patients remains elusive. Aim. To examine the potential effects of PPI use on the clinical outcomes of COVID-19 patients in a territory-wide cohort. Methods. A retrospective cohort study was performed using data from a territory-wide database in Hong Kong. Patients diagnosed with COVID-19 from 23 January 2020 to 1 January 2021 were identified by virological results. The primary endpoint was a composite of intensive care unit admission, use of invasive mechanical ventilation, and/or death. PPI users were identified by PPI use within 12 months prior to their diagnosis of COVID-19. Results. We identified 8,675 COVID-19 patients (mean age 46 years, 49% male, 97.6% of all reported cases in Hong Kong), of which 579 (6.7%) patients had used PPI. PPI users were found to be older, more likely to have comorbidities, concomitant medications and unfavourable laboratory parameters than nonusers. Of the 8,675 COVID-19 patients, 500 (5.8%) developed the primary endpoint. After propensity score (PS) balancing for patients’ demographics, comorbidities, laboratory parameters, and use of medications, PPI use was not found to be associated with the development of primary endpoint in PS weighting (weighted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.82–1.46, \u0000 \u0000 P\u0000 =\u0000 0.529\u0000 \u0000 ), and PS matching analysis (weighted HR 0.79, 95% CI 0.56–1.13, \u0000 \u0000 P\u0000 =\u0000 0.198\u0000 \u0000 ). Consistent nonassociation was observed after multivariable adjustment (adjusted HR 0.84, 95% CI 0.67–1.06, \u0000 \u0000 P\u0000 =\u0000 0.142\u0000 \u0000 ), and in subgroups of current and past PPI users. Conclusion. PPI use is not found to be associated with adverse clinical outcomes in COVID-19 patients. The result remains robust after PS weighting, PS matching, and multivariable adjustment.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82912084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lenvatinib for unresectable hepatocellular carcinoma: the first Indian experience","authors":"Anand V. Kulkarni, Syeda Fatima, Mithun Sharma, Pramod Kumar, Rajesh Gupta, Nagaraja R. Padaki, Nageshwar Reddy","doi":"10.1002/ygh2.477","DOIUrl":"https://doi.org/10.1002/ygh2.477","url":null,"abstract":"","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 6","pages":"407-408"},"PeriodicalIF":0.0,"publicationDate":"2021-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71989051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GastroHep Asian Special Edition","authors":"Her Hsin Tsai","doi":"10.1002/ygh2.498","DOIUrl":"https://doi.org/10.1002/ygh2.498","url":null,"abstract":"","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 6","pages":"338"},"PeriodicalIF":0.0,"publicationDate":"2021-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71971156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GastroHep Asian Special Edition","authors":"H. Tsai","doi":"10.1002/ygh2.498","DOIUrl":"https://doi.org/10.1002/ygh2.498","url":null,"abstract":"","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87722623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Helicobacter pylori detection rate by using combination of rapid urease test at antrum and body vs histopathology in population who stop proton pump inhibitor less than 2 weeks","authors":"Pitchayut Boonyabaramee,&nbsp;Rapat Pittayanon,&nbsp;Anapat Sunpavat,&nbsp;Nathawadee Lerttanatum,&nbsp;Natee Faknak,&nbsp;Naruemon Wisedopas","doi":"10.1002/ygh2.496","DOIUrl":"https://doi.org/10.1002/ygh2.496","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H pylori</i>) assessment in patients who stop taking proton pump inhibitor (PPI) in less than 2 weeks has never been established. Experts have suggested using pathology rather than rapid urease test (RUT). Unfortunately, pathology is not widely available in limited resource areas. We aimed to evaluate the detection rate of RUT at antrum and body compared with pathology in those patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-seven patients with history of PPI use for at least 2 weeks and continued use within 2 weeks prior to gastroscopy were enrolled. Two biopsies were taken from antrum and body for RUT and pathology. Positive test was determined by either RUT or haematoxylin and eosin and giemsa or immunohistochemistry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most patients were female (71.6%) with mean age of 52 years. Mean duration of PPI withhold was 3.6 ± 3.8 days. Nearly half (41.8%) were documented <i>H pylori</i> infection in this study. Detection rate of RUT and histopathology was 28.3% and 23.9% at antrum (<i>P</i> = .54, RR 1.18, 95% CI 0.67-2.11) and 34.3% and 28.4% at body (<i>P</i> = .28, RR 0.28, 95% CI 0.73-2.01) respectively. The detection rate was up to 38.8% when combining RUT at antrum and body but did not change when combining those locations for pathology (28.4%) (<i>P</i> = .06, RR 1.37, 95% CI 0.84-2.22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients who have been recently taking PPI, the <i>H pylori</i> detection rate from combination of RUT at antrum and body is not different from pathology. In case where cost may be of concern, RUT from both antrum and corpus can be considered as the diagnostic tool. (ClinicalTrials.gov: NCT04233684).</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 6","pages":"339-343"},"PeriodicalIF":0.0,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71959511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality pattern in cirrhosis: A reflection of liver disease burden in India","authors":"Debashis Misra,&nbsp;Kausik Das,&nbsp;Saswata Chatterjee,&nbsp;Parthasarathi Mukherjee,&nbsp;Abhijit Chowdhury","doi":"10.1002/ygh2.497","DOIUrl":"https://doi.org/10.1002/ygh2.497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction and objective</h3>\u0000 \u0000 <p>Mortality data from high-income group countries are frequently used in developing countries for healthcare planning. This study was planned to explore the mortality pattern of cirrhosis in India in terms of survival after diagnosis of cirrhosis, predictors of death and aetiology specific effect on mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study enrolled newly diagnosed patients with liver disease (n = 3193) attending a tertiary care hospital in Kolkata, India between April 2010 and October 2012 and were followed up to September 2015.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with cirrhosis having complete follow-up data (n = 702) were analysed. Median follow-up duration was 21 months (range: 1-84 months). Mortality among them was 51% (n = 358 out of 702). Development of HCC (OR 2.8: 95%CI 1.8-4.2, <i>P</i> &lt; 0.0001), male gender (OR 1.4: 95% CI 1.0-1.8, <i>P</i> = 0.009) and higher Child score at the time of diagnosis (OR 1.2: 95%CI 1.1-1.3, <i>P</i> &lt; 0.0001) were predictors of mortality. Survival after the diagnosis of cirrhosis was significantly shorter in alcohol (16.5 month; range 1-51)- and HCV (16 month; range 1-48)-related cirrhosis in comparison to HBV (23 month; range 1-48)-related and cryptogenic cirrhosis (22 month; range 1-84) (<i>P</i> = 0.014).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Majority of the patients with cirrhosis had decompensation at the time of diagnosis. Shorter survival was noticed in alcohol- and HCV-related cirrhosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 6","pages":"409-416"},"PeriodicalIF":0.0,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71939529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification of hepatocellular carcinoma in patients with chronic liver disease by combining gadolinium-ethoxybenzyl diethylenetriamine-pentaacetic acid–enhanced magnetic resonance imaging and magnetic resonance elastography","authors":"Emi Meren,&nbsp;Yoshiyuki Sawai,&nbsp;Kazuto Fukuda,&nbsp;Takumi Igura,&nbsp;Sachiyo Kogita,&nbsp;Yoshihiro Yukimura,&nbsp;Yasushi Seki,&nbsp;Norihiko Fujita,&nbsp;Masahide Oshita,&nbsp;Yasuharu Imai","doi":"10.1002/ygh2.495","DOIUrl":"https://doi.org/10.1002/ygh2.495","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Liver stiffness (LS) as measured by magnetic resonance elastography (MRE) and the presence of intrahepatic nonhypervascular hypointense nodules (NHHNs) during the hepatobiliary phase of gadolinium-ethoxybenzyl diethylenetriamine-pentaacetic acid–enhanced magnetic resonance imaging are non-invasive MR-based biomarkers of hepatocarcinogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively evaluated the ability of these two MR-based biomarkers to stratify the risk of hepatocellular carcinoma (HCC) development in patients with chronic liver disease. Between September 2013 and April 2020, 868 consecutive patients underwent MRE and gadolinium-ethoxybenzyl diethylenetriamine-pentaacetic acid–enhanced magnetic resonance imaging, among whom 487 were enrolled in this study. Factors associated with hepatocarcinogenesis were analysed by a Cox proportional hazard model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two patients developed hypervascular HCC. According to the time-dependent receiver operating characteristic analysis, an LS value of 3.94 kPa was selected as the optimal cut-off value for predicting HCC development. Multivariate analyses identified high LS (≥3.94 kPa) and the presence of NHHN as independent predictive factors for HCC development. Patients were classified as follows: high LS/NHHN+ (Group 1), high LS/NHHN− (Group 2), low LS/NHHN+ (Group 3) and low LS/NHHN− (Group 4). The 5-year incidence rates of HCC in Groups 1, 2, 3 and 4 were 49.0%, 16.3%, 10.0% and 2.5% respectively. The HCC development rate was highest in Group 1 and lowest in Group 4 (<i>P</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MRE-based LS measurements and the presence of NHHN are useful biomarkers to stratify the risk of HCC development among chronic liver disease patients. Combining these biomarkers can provide a detailed classification of the risk of HCC development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"3 7","pages":"435-442"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71991047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori eradication by low‐dose rifabutin triple therapy (RHB‐105) is unaffected by high body mass index","authors":"J. Kao, J. Almenoff, Dana D. Portenier, Kely L. Sheldon","doi":"10.1002/ygh2.494","DOIUrl":"https://doi.org/10.1002/ygh2.494","url":null,"abstract":"Helicobacter pylori infection affects ~35% of Americans and may lead to serious sequelae if left untreated, including gastric cancer. Obesity is a significant risk factor for antibiotic treatment failure; however, little work has been done to understand the influence of high body mass index (BMI) on the success rates of H pylori eradication regimens in treatment‐naïve and refractory adult patients.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"64 1","pages":"426 - 434"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91539860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification of hepatocellular carcinoma in patients with chronic liver disease by combining gadolinium‐ethoxybenzyl diethylenetriamine‐pentaacetic acid–enhanced magnetic resonance imaging and magnetic resonance elastography","authors":"E. Meren, Yoshiyuki Sawai, K. Fukuda, T. Igura, S. Kogita, Yoshihiro Yukimura, Y. Seki, Norihiko Fujita, M. Oshita, Y. Imai","doi":"10.1002/ygh2.495","DOIUrl":"https://doi.org/10.1002/ygh2.495","url":null,"abstract":"Liver stiffness (LS) as measured by magnetic resonance elastography (MRE) and the presence of intrahepatic nonhypervascular hypointense nodules (NHHNs) during the hepatobiliary phase of gadolinium‐ethoxybenzyl diethylenetriamine‐pentaacetic acid–enhanced magnetic resonance imaging are non‐invasive MR‐based biomarkers of hepatocarcinogenesis.","PeriodicalId":12480,"journal":{"name":"GastroHep","volume":"1 1","pages":"435 - 442"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83187874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}