Przegla̜d Gastroenterologiczny最新文献

{"title":"Clinical and magnetic resonance imaging features predict microvascular invasion in intrahepatic cholangiocarcinoma.","authors":"Jin-Jun Sun,&nbsp;Xian-Ling Qian,&nbsp;Yi-Bing Shi,&nbsp;Yu-Fei Fu,&nbsp;Chun Yang,&nbsp;Xi-Juan Ma","doi":"10.5114/pg.2022.116668","DOIUrl":"https://doi.org/10.5114/pg.2022.116668","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical features and magnetic resonance imaging (MRI)-related data are commonly employed in clinical settings and can be used to predict the microvascular invasion (MVI) status of intrahepatic cholangiocarcinoma (ICC) patients.</p><p><strong>Aim: </strong>To generate a clinical and MRI-based model capable of predicting the MVI status of ICC patients.</p><p><strong>Material and methods: </strong>Consecutive ICC patients evaluated from June 2015 to December 2018 were retrospectively enrolled in a training group to establish a predictive clinical MRI model. Consecutive ICC patients evaluated from January 2019 to June 2019 were prospectively enrolled in a validation group to test the reliability of this model.</p><p><strong>Results: </strong>In total, 143 patients were enrolled in the training group, of whom 46 (32.2%) and 96 (67.8%) were MVI-positive and MVI-negative, respectively. Logistics analyses revealed larger tumour size (<i>p</i> = 0.008) and intrahepatic duct dilatation (<i>p</i> = 0.01) to be predictive of MVI positivity, enabling the establishment of the following predictive model: -2.468 + 0.024 × tumour size + 1.094 × intrahepatic duct dilatation. The area under the receiver operating characteristic (ROC) curve (AUC) for this model was 0.738 (<i>p</i> < 0.001). An optimal cut-off value of -1.0184 was selected to maximize sensitivity (71.7%) and specificity (61.9%). When the data from the validation group were incorporated into the predictive model, the AUC value was 0.716 (<i>p</i> = 0.009).</p><p><strong>Conclusions: </strong>Both larger tumour size and intrahepatic duct dilatation were predictive of MVI positivity in patients diagnosed with ICC, and the predictive model developed based on these variables can offer quantitative guidance for assessing the risk of MVI.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/13/PG-18-47137.PMC10395063.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9941883","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":"How does cirrhosis impact mortality, morbidity, and resource utilization in non-variceal upper gastrointestinal bleeding? A nationwide analysis.","authors":"Umer Farooq,&nbsp;Zahid Ijaz Tarar,&nbsp;Adnan Malik,&nbsp;Muhammad Kashif Amin,&nbsp;Humberto Sifuentes","doi":"10.5114/pg.2022.115232","DOIUrl":"https://doi.org/10.5114/pg.2022.115232","url":null,"abstract":"<p><strong>Introduction: </strong>Upper gastrointestinal bleeding is common in liver cirrhosis patients. Studies have described the prognostic impact of liver disease in non-variceal upper gastrointestinal bleeding (NVUGIB), but a direct subgroup comparison is lacking using a large database.</p><p><strong>Aim: </strong>To study the impact of NVUGIB on hospital-based outcomes in patients with cirrhosis.</p><p><strong>Material and methods: </strong>This is a retrospective study using Nationwide Inpatient Sample (NIS) employing International Classification of Diseases (ICD-10) codes for adult patients with a primary diagnosis of NVUGIB. Mortality, morbidity, and resource utilization were compared. Analyses were performed using STATA, proportions were compared using Fisher exact test, and continuous variables using Student's <i>t</i>-test. Confounding variables were adjusted using propensity matching, multivariate logistic, and linear regression analyses.</p><p><strong>Results: </strong>Of 107,001,355 discharges, 957,719 had a diagnosis of NVUGIB. Of those, 92,439 had cirrhosis upon admission. NVUGIB patients with cirrhosis had higher adjusted odds of mortality and intensive care unit (ICU) admission than patients without cirrhosis (adjusted odds ratio (AOR) for mortality 1.31, <i>p</i> < 0.001, ICU admission AOR = 1.29, <i>p</i> < 0.001). NVUGIB patients with cirrhosis had shorter length of stay (LOS) by 0.44 days (<i>p</i> < 0.001), greater hospital costs per day ($3114 vs. $2810, <i>p</i> < 0.001), and lower odds of acute kidney injury (AOR = 0.81, <i>p</i> < 0.001). In addition, the cirrhotic patients had higher odds of receiving endoscopic therapy (AOR = 1.08, <i>p</i> < 0.001). There was no difference between the 2 groups' requirements of packed red blood cell transfusion, parenteral nutrition, hypovolaemic shock, and endotracheal intubation. We also identified novel independent predictors of mortality from NVUGIB in cirrhosis patients.</p><p><strong>Conclusions: </strong>Cirrhosis presents greater mortality and morbidity burden and greater healthcare resource utilization from NVUGIB.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/ce/PG-18-46804.PMC10395061.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9941887","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":"Common peritoneal disorders: what the physician should know.","authors":"Elroy Patrick Weledji","doi":"10.5114/pg.2023.133071","DOIUrl":"https://doi.org/10.5114/pg.2023.133071","url":null,"abstract":"<p><p>Diseases affecting the peritoneum are diverse, ranging from reactive to neoplastic. The abdomen with its peritoneal cavity is part of the body in which diseases are usually thought to be diagnosed and treated almost exclusively by surgeons. However, it is often the general physician who is faced with the initial diagnosis of many of the common diseases of the region, the diagnosis of which may be very difficult. In addition, many chronic lesions that may require surgical treatment may first be seen by the general physician or gastroenterologist. For these reasons, some of the common peritoneal disorders, their presentation, and treatment are reviewed.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874787","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 novel stent fixation method for anastomotic leaks after gastrectomy: anchoring of the distal flare to the jejunum by using through-the-scope endoclips.","authors":"Serdar Şenol, Dursun Burak Özdemir","doi":"10.5114/pg.2022.121045","DOIUrl":"10.5114/pg.2022.121045","url":null,"abstract":"<p><strong>Introduction: </strong>An anastomotic leak is a life-threatening complication after gastrectomy. A fully covered, self-expandable, metal stent (FC-SEMS) can be used as an alternative to traditional surgical re-intervention. However, stent migration can be worrisome.</p><p><strong>Aim: </strong>To evaluate the feasibility and effectiveness of anchoring of the distal flare of the FC-SEMS to the jejunum by using through-the-scope (TTS) endoclips to prevent stent migration.</p><p><strong>Material and methods: </strong>Patients, who received a FC-SEMS capable of being fixed to the jejunum by using TTS endoclips due to an anastomotic leak after gastrectomy, were reviewed retrospectively. Demographic and clinical characteristics, the properties of the deployed stents, and outcomes were evaluated.</p><p><strong>Results: </strong>A total of 7 patients underwent FC-SEMS placement. The mean age was 59 ±13.8 years, and the mean body mass index was 29.8 ±8.4 kg/m². All patients' American Society of Anesthesiologists scores were between II and IV. The mean time between gastrectomy and stent insertion was 6.7 ±6.1 days. Technical success was achieved in all patients. Stent migration was not observed in any of the patients. All but one were removed between 4 and 6 weeks after placement. The mean stent removal time was 37 ±4.6 days. Complete resolution of the leak was achieved in 6 patients.</p><p><strong>Conclusions: </strong>Anchoring of the distal flare of the FC-SEMS to the jejunum with TTS endoclips is feasible and may reduce the risk of migration. This inexpensive and safe technique may be proposed to patients with factors predictive of FC-SEMS migration.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70475093","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":"Stent insertion for malignant hilar obstruction: a meta-analysis of percutaneous versus endoscopic approaches","authors":"G. Wang, Yu Fu, Yanyan Yu","doi":"10.37766/inplasy2022.11.0156","DOIUrl":"https://doi.org/10.37766/inplasy2022.11.0156","url":null,"abstract":"","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45027817","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":"An unusual cause of abdominal pain","authors":"Wiktoria Feret, Katarzyna Gaweł, Patrycja Krynicka, Teresa Starzyńska, W. Marlicz, Wojciech Poncyljusz","doi":"10.5114/pg.2022.116390","DOIUrl":"https://doi.org/10.5114/pg.2022.116390","url":null,"abstract":"Gastroent Question: An 88year-old woman was admitted to our hospital complaining of upper abdominal and back pain. She had a history of hypertension. On admission, she was febrile with a temperature of 38.4 C, blood pressure was 122/54 mmHg, and her pulse rate was 84 beats per minute. Her abdomen was soft, nondistended, and nontender. Admission blood work revealed a white blood cell count of 7,800/mm. Her liver panel showed a total bilirubin of 1.1 mg/dL (normal, 0.1-1.1); alanine aminotransferase, 62 IU/L (normal, 3-49); aspartate aminotransferase, 47 IU/L, (normal, 9-37); alkaline phosphatase, 438 IU/L, (normal, 104-338); and g-glutamyl transpeptidase, 168 IU/L (normal, 671). Tumor markers were normal: carcinoembryonic antigen, 2.4 ng/mL (normal, <5.0) and carbohydrate antigen 19-9, 17 U/mL (normal, <37). To evaluate further the abnormal liver enzymes, abdominal ultrasound followed by a contrastenhanced CT of the abdomen was performed (Figure A). Side-viewing endoscope showed duodenal papilla (Figure B). What are the findings of the abdominal CT and side-viewing endoscope and what is the diagnosis? See the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70474567","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 role of vitamin and microelement supplementation in the treatment of ethanol-induced liver disease.","authors":"Artur W Uździcki,&nbsp;Aleksandra Zych,&nbsp;Barbara A Świerad,&nbsp;Marta Wawrzynowicz-Syczewska","doi":"10.5114/pg.2022.121820","DOIUrl":"https://doi.org/10.5114/pg.2022.121820","url":null,"abstract":"<p><p>High alcohol intake leads to an inadequate diet and impaired absorption, transport, and utilization of nutrients in the body, which results in malnutrition. Micronutrient supplementation, such as vitamins A, E, group B vitamins, folic acid zinc, and selenium may have a positive effect on those patients. In this article, the actual supplementation recommendations for vitamins and microelements in ethanol-induced liver disease patients are presented.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/ef/PG-17-48403.PMC9743330.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10360187","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":"Clinical and genetic characterization of familial Mediterranean fever among a cohort of Egyptian patients.","authors":"Mohammed Hussien Ahmed,&nbsp;Omar El Henawy,&nbsp;Eslam Mohamed ElShennawy,&nbsp;Aya Mohamed Mahros","doi":"10.5114/pg.2022.118595","DOIUrl":"https://doi.org/10.5114/pg.2022.118595","url":null,"abstract":"<p><strong>Introduction: </strong>Familial Mediterranean fever (FMF) is an autosomal recessive disease with an autoinflammatory nature. It affects mainly Turkish, Armenian, Arab, and Jewish people. The clinical presentation and the development of complication as amyloidosis. Early diagnosis and predilection of disease severity according to gene mutation facilitates adequate treatment and disease control.</p><p><strong>Aim: </strong>To our knowledge, few studies were done to evaluate FMF in lower Egypt.</p><p><strong>Material and methods: </strong>This is a prospective study that was carried out at Kafrelsheikh University Hospital Outpatient Clinic between March 2019 and February 2020. We recruited all patients who came to our outpatient clinic with symptoms suggestive of FMF (recurrent attacks of abdominal pain and fever), and diagnosis of FMF was confirmed by gene study. One hundred and nine patients were included; however, 9 patients refused to participate in the study, so final analysis was done for 100 patients only. Patients also underwent abdominal ultrasound examination for measurement of the spleen longitudinal diameter.</p><p><strong>Results: </strong>E148Q mutant allele was the most encountered mutation in our studied patients at Kafrelsheikh, with a frequency of 31%; the number of attacks was greater in patients with positive family history and in homozygous patients. Most patients required a dose between 1.5 and 3 mg/day.</p><p><strong>Conclusions: </strong>Patients with positive family history and those with homozygous mutation have more attacks with greater severity and higher amyloid deposition. E148Q mutant allele was the most commonly encountered in the studied patients, with a frequency of 31%, followed by M6801 (G/A), which was associated with the highest amyloid A level.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/d2/PG-17-47597.PMC9475472.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373748","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":"Gastrointestinal symptoms in patients with coronavirus disease 2019 (COVID-19) - friend or foe?","authors":"Konrad Lewandowski,&nbsp;Magdalena Kaniewska,&nbsp;Mariusz Rosołowski,&nbsp;Adam Tworek,&nbsp;Grażyna Rydzewska","doi":"10.5114/pg.2021.111000","DOIUrl":"https://doi.org/10.5114/pg.2021.111000","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal (GI) symptoms can be considered as a manifestation of coronavirus disease 2019 (COVID-19).</p><p><strong>Aim: </strong>Our study analysed GI symptoms depending on their occurrence, and their possible causes and impact on the course of COVID-19.</p><p><strong>Material and methods: </strong>A retrospective, single-centre assessment of the frequency, risk factors, and impact of GI symptoms in 441 patients with COVID-19.</p><p><strong>Results: </strong>A statistically significant reduction in the length of stay (LOS) (15 days vs. 17 days; <i>p</i> = 0.04), intensive care unit admission (ICU) (16.9% vs. 26.8%; <i>p</i> = 0.02), and need for mechanical ventilation (14.1% vs. 23.4%; <i>p</i> = 0.02) in the group who had experienced GI symptoms before hospitalization was noticed. For comparison, patients who developed GI symptoms during hospitalization had statistically significantly longer LOS (21 days vs. 15 days; <i>p</i> = 0.0001), were more frequently admitted to the ICU (38.1% vs. 18.6%; <i>p</i> = 0.0003), and had a higher need for mechanical ventilation (32.7% vs. 16.2%; <i>p</i> < 0.001). Risk factors for GI symptoms during hospitalization in COVID-19 patients included age, <i>Clostridioides difficile</i> infection, and receiving certain treatment (antibiotics and lopinavir + ritonavir).</p><p><strong>Conclusions: </strong>The GI symptoms that developed before admission to hospital correlated with reduced severity of the course of COVID-19. However, in the group of patients who developed GI symptoms during hospitalization, attention should be paid to concomitant treatment. The use of antibiotics should be limited because they are associated with the deterioration of the course of COVID-19; one of the reasons might be changes in the intestinal microbiome.</p>","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/26/PG-17-45680.PMC9475485.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373750","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":"Fibrolamellar hepatocellular carcinoma presenting with early recurrent thrombosis.","authors":"Hacer Kundakcioglu,&nbsp;Sabahattin Destek,&nbsp;Zuhal Gucin,&nbsp;Kamuran Cumhur Değer","doi":"10.5114/pg.2022.121827","DOIUrl":"https://doi.org/10.5114/pg.2022.121827","url":null,"abstract":"","PeriodicalId":20719,"journal":{"name":"Przegla̜d Gastroenterologiczny","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ab/eb/PG-17-48410.PMC9743328.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10366782","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}