Journal of Digestive Diseases最新文献

{"title":"An Open-Label Randomized Controlled Non-Inferiority Trial of Arginine Glutamate Injection for the Treatment of Mild Hepatic Encephalopathy","authors":"Hai Bo Zhang,&nbsp;Huai Bin Zou,&nbsp;Yun Yi Gao,&nbsp;Li Wang,&nbsp;Yuan Gao,&nbsp;Ming Kong,&nbsp;Wei Wei Kang,&nbsp;Rui Zhong,&nbsp;Xian Shan Yang,&nbsp;Yan Ren,&nbsp;Li Li Feng,&nbsp;Lu Li,&nbsp;Shuang Li,&nbsp;Zhong Ping Duan,&nbsp;Yu Tao Zhan,&nbsp;Yu Chen","doi":"10.1111/1751-2980.13355","DOIUrl":"10.1111/1751-2980.13355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the efficacy and safety profile of arginine glutamate and L-ornithine-L-aspartate (LOLA) in treating mild hepatic encephalopathy (HE) and hyperammonemia in cirrhotic patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, open-label, non-inferiority, randomized controlled trial (RCT) enrolled patients aged 18–75 years with cirrhosis and mild HE. The patients were randomly allocated in the ratio of 1:1 using a randomization table to be treated with intravenous administration of arginine glutamate or LOLA for 7 days. The primary end-point was the clinical improvement of mild HE. Secondary end-points included post-treatment change in blood ammonia level and the time to complete the number connection test (NCT)-A. Adverse events and adverse drug reactions were documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From July 2020 to June 2021, 108 cirrhotic patients with mild HE were included and randomized to receive either arginine glutamate or LOLA for 7 days. Clinical improvement was observed in 88.9% of the patients receiving arginine glutamate and 90.7% of those having LOLA (between-group difference −1.9%, 95% confidence interval −13.3% to 9.6%), indicating non-inferiority of arginine glutamate to LOLA. The two groups showed comparable reductions in blood ammonia levels and improvements in time to complete NCT-A. The rate of adverse events was similar between the two groups, with only four cases reported adverse drug reactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both regimens effectively alleviated mild HE symptoms and reduced ammonia levels. Arginine glutamate showed non-inferiority to LOLA in terms of clinical improvement, ammonia reduction, and time to complete NCT-A, with no significant adverse events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"241-249"},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368880","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}

{"title":"Alexithymia in Functional Defecation Disorder: The Incidence and the Effect on Treatment","authors":"Sai Nan Shi,&nbsp;Bin Bin Zhu,&nbsp;Mei Feng Wang,&nbsp;Lin Lin,&nbsp;Liu Qin Jiang","doi":"10.1111/1751-2980.13356","DOIUrl":"10.1111/1751-2980.13356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to investigate the prevalence of alexithymia in patients with functional defecation disorder (FDD) and its impact on treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FDD patients who underwent high-resolution anorectal manometry and balloon expulsion test were enrolled. Symptoms, anorectal function, and treatment efficacy were assessed at baseline and after 4-week medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Alexithymia was present in 29.5% of all 129 FDD patients. Compared to the non-alexithymia group, the alexithymia group had higher baseline scores for the Patient Assessment of Constipation-Symptoms (PAC-SYM) (19.0 vs. 15.0, <i>p</i> = 0.03), Patient Assessment of Constipation-Quality of Life (PAC-QOL) (67.0 vs. 26.0, <i>p</i> &lt; 0.001), Zung's Self-Rating Anxiety Scale (SAS) (44.5 vs. 30.0, <i>p</i> &lt; 0.001), and Self-Rating Depression Scale (SDS) (48.0 vs. 33.0, <i>p</i> &lt; 0.001). Moreover, the improvements in post-treatment complete spontaneous bowel movements (CSBMs) (0.0 vs. 1.5, <i>p</i> = 0.041), PAC-SYM (0.0 vs. −11.5, <i>p</i> &lt; 0.001), PAC-QOL (0.0 vs. −16.0, <i>p</i> &lt; 0.001), SAS (0.0 vs. −1.0, <i>p</i> &lt; 0.001), and SDS (0.0 vs. −3.0, <i>p</i> &lt; 0.001) scores were less significant in the alexithymia group than in the non-alexithymia group. A high Toronto Alexithymia Scale-20 score was an independent risk factor for drug therapy failure in FDD patients (odds ratio 0.949, 95% confidence interval 0.919–0.980, <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Alexithymia is prevalent in FDD patients and significantly affects symptom severity, quality of life, mental state, and treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"212-220"},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333187","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}

{"title":"Outcomes of Fecal Diversion in Perianal Crohn's Disease: A Systematic Review and Meta-Analysis","authors":"Imogen Hartley,&nbsp;Babak Sarraf,&nbsp;Helen Wilding,&nbsp;Jonathan P. Segal,&nbsp;Nik Sheng Ding","doi":"10.1111/1751-2980.13354","DOIUrl":"10.1111/1751-2980.13354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Perianal fistulizing Crohn's disease (pfCD) is a severe type of inflammatory bowel disease resulting in significant patient morbidity. Despite advancements in treatments, pfCD remains challenging to manage with low healing rates. Fecal diversion (FD) has previously demonstrated clinical improvement for patients with refractory disease. Our meta-analysis aimed to explore the clinical response to FD, rates of successful restoration of bowel continuity after FD, rates of re-diversion, and factors affecting the success of FD in pfCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was carried out of adult patients who had undergone FD for pfCD, with detailed patient outcome data. Studies were identified through a literature search of six bibliographic databases and one trial register, all run on February 28, 2025, including MEDLINE ALL, EMBASE, Emcare, APA PsycInfo, CINAHL, Cochrane Library, and Clinicaltrials.gov.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies encompassing 714 adult pfCD patients were included. FD resulted in a 65% clinical improvement rate, yet considerable heterogeneity existed in study methodologies and outcome definitions. While 29% of patients achieved bowel restoration within a median follow-up of 58.2 months, challenges in sustaining the effects were evident, with 10% requiring repeat diversion and a 37% overall proctectomy/proctocolectomy rate. Factors associated with diversion success included the absence of rectal involvement and quiescent luminal disease, with biologic use showing no impact on outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FD offers symptom control in pfCD, although restoration rates remain low. These findings emphasize the need for individualized patient counseling. Future research should strive for uniform measures and refined approaches to enhance pfCD management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"180-192"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302209","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}

{"title":"Screening and Analysis of the Clinical Characteristics of Celiac Disease Autoimmunity in the Young Population in Northwest China","authors":"Tian Shi,&nbsp;Sheng Long Xue,&nbsp;Wei Dong Liu,&nbsp;Yan Feng,&nbsp;Ting Li,&nbsp;Na Li,&nbsp;Kuerbanjiang Aihemaijiang,&nbsp;Xiao Ling Huang,&nbsp;Wen Jia Hui,&nbsp;Qi Jiang,&nbsp;Ying Xuan Chen,&nbsp;Feng Gao","doi":"10.1111/1751-2980.13351","DOIUrl":"10.1111/1751-2980.13351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to evaluate the prevalence of celiac disease (CeD) autoimmunity among young adult individuals in northwest China based on their relevant demographics, clinical characteristics, and laboratory data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional survey of serum CeD prevalence among young students aged 18–23 years who underwent routine physical examinations at the Xinjiang Second Medical College from September 2022 to December 2023. All subjects were tested for total serum immunoglobulin (Ig) A levels. Those with normal total IgA levels were tested for anti-tissue transglutaminase (tTG)-IgA and anti-endomysial antibody (EMA)-IgA. Individuals with IgA deficiency were tested for anti-deamidated gliadin peptide (DGP) IgG and anti-EMA-IgG. CeD autoimmunity was defined as positivity for both EMA and tTG/DGP antibodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1464 participants, CeD seropositivity rates were 0.41% for tTG-IgA and 0.55% for EMA-IgA, and CeD autoimmunity was prevalent in 0.34%. All seropositive patients had a normal body mass index. The incidence of seropositivity was highest in Tajiks (1.28%), followed by Kazakhs (0.97%), Hans (0.29%), and Uygurs (0.22%) (<i>p</i> &gt; 0.05). CeD was most frequently associated with elevated transaminase levels (1.87%; <i>p</i> = 0.005). Biochemical tests showed significantly higher alanine aminotransferase levels in CeD-positive patients (<i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of CeD autoimmunity in the young adult population of northwest China was 0.34%. Since young individuals often lack typical clinical and laboratory features, screening for CeD in the population with gastrointestinal symptoms, related comorbidities, or atypical manifestations is essential for early diagnosis and effective management of the disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"143-149"},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284901","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}

{"title":"Same-Day Discharge, Medical and Non-Medical Admission After Per-Oral Endoscopic Pyloromyotomy","authors":"Brittany Pass,&nbsp;Michelle Neice,&nbsp;Karan Sachdeva,&nbsp;Natalie Roppolo,&nbsp;Ahmad Alkurd,&nbsp;Farhan Mohuiddin,&nbsp;Elizabeth Armstrong,&nbsp;Ross Dies,&nbsp;Victoria Andrus,&nbsp;Ashely Deville,&nbsp;David Okuampa,&nbsp;Lena Kawji,&nbsp;Michael P. Tran,&nbsp;Omar Khan,&nbsp;Qiang Cai","doi":"10.1111/1751-2980.13353","DOIUrl":"10.1111/1751-2980.13353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gastric per-oral endoscopic myotomy (G-POEM) is a promising treatment for gastroparesis. Our previous pilot study has indicated that about 50% of patients could be safely discharged home on the same day as the procedure. In this study, we presented more data on this topic and divided admission into medical and non-medical admissions to assess the safety of same-day discharge after the G-POEM procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients who underwent G-POEM for gastroparesis at our institution from April 2022 to June 2023 were included. After undergoing G-POEM, patients who met the following four criteria would be discharged on the same day: (i) no major complications during the procedure; (ii) patient having abdominal pain scored 4 or less on a pain scale from 0 to 10, or &gt; 4 but improved after having one dose of intravenous pain medication; (iii) no vomiting after the procedure; and (iv) the patient had someone at home to help them access medical care when necessary. The admitted patients were divided into two groups: those with medical issues, and those with non-medical issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 61 consecutive patients were included in this study, among whom 40 (65.6%) were discharged on the same day. Among the 21 (34.4%) patients who were admitted to the hospital for observation, 12 were admitted for non-medical issues. The remaining nine (14.8%) patients were admitted for medical issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>After about 10 years of practice, G-POEM is a safe endoscopic therapeutic modality. This study shows that 85.2% of patients undergoing G-POEM can be discharged on the same day.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"135-142"},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284900","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}

{"title":"Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Biopsy for Rectal and Perirectal Lesions With Categorization of Their Indications","authors":"June Hwa Bae,&nbsp;Jung-Bin Park,&nbsp;Ji Eun Baek,&nbsp;Seung Wook Hong,&nbsp;Sung Wook Hwang,&nbsp;Sang Hyoung Park,&nbsp;Dong-Hoon Yang,&nbsp;Byong Duk Ye,&nbsp;Seung-Jae Myung,&nbsp;Suk-Kyun Yang,&nbsp;Jeong-Sik Byeon","doi":"10.1111/1751-2980.13352","DOIUrl":"10.1111/1751-2980.13352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic ultrasound-guided fine-needle aspiration and/or biopsy (EUS-FNA/B) is a diagnostic tool for gastrointestinal (GI) lesions. However, its effectiveness in the lower GI tract remains underreported. In this study, we aimed to evaluate the clinical utility of EUS-FNA/B for rectal and perirectal lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-seven consecutive patients with rectal or perirectal lesions underwent EUS-FNA/B between 2009 and 2023. The histological diagnoses by EUS-FNA/B were compared with the final diagnoses to assess the former's diagnostic performance. Additionally, the therapeutic utility of EUS-FNA/B and its clinical applicability across various scenarios were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine of the 77 patients had rectal lesions, with gastrointestinal stromal tumor (GIST) being the most common in 15 patients. Of the 48 patients with perirectal lesions, 27 and 21 had malignant and benign lesions, respectively. EUS-FNA/B was diagnostic in 61 (79.2%) patients, with the rates of 79.3% and 79.2% for rectal and perirectal lesions. EUS-FNA/B enabled timely treatment decisions by confirming malignancy (<i>n</i> = 32) and prevented unnecessary surgeries/procedures by establishing the benign nature of the lesions (<i>n</i> = 14). A definitive diagnosis of rectal GIST was made using EUS-FNA/B, thereby facilitating the initiation of neoadjuvant chemotherapy followed by anus-saving surgery (<i>n</i> = 10). EUS-FNA/B enabled the implementation of minimally invasive interventions such as EUS-guided drainage (<i>n</i> = 5). Adverse events occurred in five (6.5%) patients, with only one requiring hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EUS-FNA/B is a valuable modality for patients with rectal or perirectal lesions, which facilitates accurate histological diagnosis, appropriate treatment, and favorable safety profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"193-202"},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258182","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}

{"title":"The Biliary Stenting Strategy for the Unresectable Hilar Type of Intrahepatic Cholangiocarcinoma: A Single-Center Experience","authors":"Cui Chen,&nbsp;Wen Chao Zhao,&nbsp;Ming Xing Xia,&nbsp;Jia Hui Zhu,&nbsp;Ting Ting Fu,&nbsp;Jun Wu,&nbsp;Zhi Yuan Yao,&nbsp;Bing Hu","doi":"10.1111/1751-2980.13350","DOIUrl":"10.1111/1751-2980.13350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Hilar-type intrahepatic cholangiocarcinoma (H-ICC), which originates from the large bile ducts, tends to invade the hepatic hilus and results in malignant hilar biliary obstruction (MHBO). Compared with hilar cholangiocarcinoma (HC), H-ICC exhibits a more aggressive biological behavior and a dismal prognosis. We aimed to investigate the optimal biliary stenting strategy for the treatment of unresectable H-ICC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with unresectable H-ICC who received endoscopic biliary stenting (EBS) between January 2012 and June 2019 were retrospectively included in this study. The prognostic factors of survival outcome, clinical success, duration of stent patency, and EBS-related adverse events were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 70 patients were enrolled, including 72.9% patients with multiple intrahepatic lesions and 44.3% with lymphatic metastasis. Jaundice control was achieved in 81.4% of the patients. Early cholangitis was the main treatment-related complication (17.1%). After successful stenting, systematic antitumor therapy was the only independent factor related to overall survival (hazard ratio [HR] 0.381, 95% confidence interval [CI] 0.218–0.668, <i>p</i> = 0.001). Plastic stenting was associated with clinical success (odds ratio [OR] 0.012, 95% CI 0.008–0.549, <i>p</i> = 0.012), stent patency (HR 6.773, 95% CI 2.221–20.653, <i>p</i> = 0.001), and early cholangitis (OR 5.000, 95% CI 1.006–24.841, <i>p</i> = 0.049). Bismuth classification IV was independently related to stent patency (HR 4.956, 95% CI 1.245–19.730, <i>p</i> = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For H-ICC-induced MHBO, metal stent placement may achieve better biliary drainage and, combined with systemic antitumor therapies, may further improve patient survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"170-178"},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208685","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}

{"title":"Association Between Metabolic Dysfunction and Gallstone Disease in U.S. Adults: An Analysis of the National Health and Nutrition Examination Survey","authors":"Yong Feng Tang,&nbsp;Yong Tian Su,&nbsp;Li Juan Liang,&nbsp;Yong Feng,&nbsp;Xiang Jiao Huang,&nbsp;Xue Lian Xiang,&nbsp;Zhi Hai Liang","doi":"10.1111/1751-2980.13349","DOIUrl":"10.1111/1751-2980.13349","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gallstones affect a significant proportion of U.S. adults and can cause serious complications. We aimed to investigate the association between gallstone disease and common metabolic disorders in a nationally representative sample in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected from 2017 to 2020. We included 6164 participants meeting the eligibility criteria, which represented 171 407 370 participants. The associations between gallstone disease and six metabolic disorders were analyzed using multivariate logistic regression analyses, accounting for potential confounding factors. Subgroup analyses were conducted by age, gender, and race.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 10.9% of participants had gallstone disease, with prevalence increasing with age (mean age with vs. without gallstones: 56.435 years vs. 46.896 years, <i>p</i> &lt; 0.001) and a female predominance (75.1% vs. 24.9%, <i>p</i> &lt; 0.001). Non-alcoholic fatty liver disease (NAFLD), obesity, hypertension, and diabetes mellitus were significantly associated with an increased risk of gallstone formation, with adjusted odds ratios (OR) of 1.523 (95% confidence interval [CI] 1.180–1.965, <i>p</i> = 0.002), 1.733 (95% CI 1.265–2.374, <i>p</i> = 0.001), 1.466 (95% CI 1.203–1.785, <i>p</i> = 0.001), and 1.522 (95% CI 1.165–1.989, <i>p</i> = 0.003), respectively. These associations were more pronounced in individuals under 60 years of age and in females. No significant associations were observed with hyperlipidemia or hyperuricemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Gallstone disease is significantly associated with obesity, NAFLD, diabetes mellitus, and hypertension, with stronger associations found in younger individuals and females. Sensitivity analyses confirmed the robustness of these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"158-169"},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150576","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}

{"title":"MMF Is an Effective and Safer Treatment Options for Treatment-Naïve Patients With Autoimmune Hepatitis Compared to Azathioprine: A Systematic Review and Meta-Analysis","authors":"Muhammad Tayyab Anwar,&nbsp;Muhammad Shahzil,&nbsp;Taha Bin Arif,&nbsp;Muhammad Ali Khaqan,&nbsp;Edzel Lorraine Co,&nbsp;Fariha Hasan,&nbsp;Rameez Tarar,&nbsp;Hamza Naeem,&nbsp;Sibgha Farooq,&nbsp;Ali Jaan,&nbsp;Ammad Javaid Chaudhary,&nbsp;Vinay Jahagirdar,&nbsp;Reena Salgia","doi":"10.1111/1751-2980.13348","DOIUrl":"10.1111/1751-2980.13348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Autoimmune Hepatitis (AIH) is a chronic inflammatory liver disease with significant morbidity and mortality if untreated. Current first-line treatment involves corticosteroids and azathioprine (AZA), which are effective but are associated with significant adverse effects and treatment intolerance. Mycophenolate mofetil (MMF), an immunosuppressive agent with a potentially better safety profile, has emerged as an alternative. This meta-analysis evaluated the efficacy and safety of MMF compared to AZA in treatment-naïve AIH patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Databases were searched for articles published up to May 2024. Statistical analysis was performed using RevMan, employing a random-effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five studies involving 621 patients were included. MMF showed significantly higher rates of complete biochemical response compared to AZA (odds ratio [OR] 3.64, 95% confidence interval [CI] 2.07–6.40, <i>p</i> &lt; 0.00001) and lower non-response rates (OR 0.45, 95% CI 0.24–0.85, <i>p</i> = 0.01). Corticosteroid withdrawal rates were also higher in the MMF group (OR 2.89, 95% CI 1.69–4.94, <i>p</i> = 0.0001). Relapse rate and cumulative prednisolone dose were comparable between the two groups. MMF demonstrated a better safety profile, with significantly lower rates of gastrointestinal symptoms (OR 0.46, 95% CI 0.27–0.79, <i>p</i> = 0.005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>\u0000 MMF shows superior efficacy and tolerability compared to AZA in treatment-naïve AIH patients and may serve as a preferred first-line therapy, offering improved patient adherence and clinical outcomes. Further randomized controlled trials are warranted to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"113-128"},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093932","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}

{"title":"The Role of Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) in Assessing the Extent and Degree of Gastric Intestinal Metaplasia","authors":"Dong Lyu,&nbsp;Jing Zhao,&nbsp;Hai Feng Jin,&nbsp;Bin Lyu","doi":"10.1111/1751-2980.13346","DOIUrl":"10.1111/1751-2980.13346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to evaluate the consistency between endoscopic grading of gastric intestinal metaplasia (EGGIM) and the operative link on gastric intestinal metaplasia assessment (OLGIM) staging, as well as the value of endoscopic grading of gastric intestinal metaplasia (GIM) in early gastric cancer (EGC) risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The sample size was estimated to be at least 210 patients. To evaluate GIM, EGGIM staging was used during magnifying endoscopy with narrow-band imaging, while the OLGIM staging was carried out according to the updated Sydney system. The consistency between the two scoring systems and the accuracy of EGGIM in diagnosing OLGIM III/IV cases were evaluated. EGC risk was evaluated using the Kimura–Takemoto classification, the operative link on gastritis assessment (OLGA)/OLGIM, and EGGIM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 210 patients, 68 (32.4%) had (previous) EGC and 142 (67.6%) had chronic atrophic gastritis (CAG). EGGIM and OLGIM staging showed good consistency (<i>κ</i> = 0.805, <i>U</i> = 12.620, <i>p</i> &lt; 0.001) in diagnosing OLGIM III/IV GIM, with an area under the receiver operating characteristic curve for EGGIM of 0.95. Using a cut-off value of &gt; 4, the sensitivity and specificity were 95.7% and 91.4%, respectively. The EGGIM score was higher in the EGC group than in the CAG group (4.93 vs. 3.92, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EGGIM shows good diagnostic performance and consistency with OLGIM, which can simplify endoscopic surveillance by reducing the need for biopsy. The EGGIM score is associated with EGC risk, and endoscopic surveillance is recommended for patients with EGGIM score &gt; 4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"129-134"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995591","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}