United European Gastroenterology Journal最新文献

{"title":"Chronic Kidney Disease Increases Risk of Delayed Post-Polypectomy Bleeding: A Large-Scale Propensity Score-Matched Analysis.","authors":"Hye Kyung Hyun, Nak-Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae-Hyun Yoo, Shin-Wook Kang, Hae-Ryong Yun, Cheal Wung Huh","doi":"10.1002/ueg2.70013","DOIUrl":"10.1002/ueg2.70013","url":null,"abstract":"<p><strong>Background: </strong>The association between delayed post-polypectomy bleeding and chronic kidney disease remains unclear.</p><p><strong>Objective: </strong>This study investigated whether patients with chronic kidney disease are at an increased risk of delayed post-polypectomy bleeding.</p><p><strong>Methods: </strong>This cohort study included patients who underwent colonoscopy and polypectomy in Korea between 2005 and 2022. We assessed various covariates, including patient-, polyp-, and procedure-related factors, using propensity score matching and inverse probability of treatment weighting to determine the impact of chronic kidney disease on delayed post-polypectomy bleeding risk.</p><p><strong>Results: </strong>Out of 21,562 patients, 16,591 with 41,014 polyps were included in the analysis. Of these, 2057 (12.4%) had chronic kidney disease, with 894 in early-stage (stages 1 and 2) and 1163 in advanced-stage (stages 3-5). There were 14,534 individuals without chronic kidney disease. After propensity score matching, the risk of delayed post-polypectomy bleeding in patients with chronic kidney disease was significantly higher than that in the non-chronic kidney disease group (OR 1.80, CI 1.12-2.89, p = 0.01). The risk increased with chronic kidney disease stage (OR 2.38, 95% CI 1.01-5.64 for early stage; OR 2.80, 95% CI 1.20-6.51 for advanced stage, all p < 0.05). The results remained robust after inverse probability analysis.</p><p><strong>Conclusions: </strong>Chronic kidney disease is an independent risk factor for delayed post-polypectomy bleeding, even in the early stages. The risk correlates with the chronic kidney disease stage. Meticulous attention is imperative during polypectomy for all patients with chronic kidney disease, including those in the early stages.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"759-772"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal Laser Ablation for Treatment of Type 2 Diabetes: Results of First in Human Study.","authors":"Viktorie Kovarova, Ivana Lankova, Evzen Machytka, Katerina Knotkova, Helena Kratochvílová, Marek Beneš, Julius Spicak, Adam Vasura, Eran Goldin, Gavriel Munter, Tomas Zima, Milos Mraz, Hila Dagan, Brian Levy, Martin Haluzik, Jan Kral","doi":"10.1002/ueg2.12762","DOIUrl":"10.1002/ueg2.12762","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) significantly impacts global health and economies. Despite various therapies, managing DM remains challenging. Bariatric surgery has shown efficacy in obese patients with type 2 diabetes mellitus (T2DM), but its utilization remains low. Innovative, less invasive endoscopic approaches such as duodenal mucosal resurfacing show potential in treating T2DM. This article presents the results of a First in Human (FIH) study using a duodenal submucosal laser ablation investigational device for T2DM treatment.</p><p><strong>Methods: </strong>A prospective, single-arm, open-label study evaluated the safety and efficacy of the Digma System Endoscopic procedure for duodenal submucosal laser ablation in consecutive enrolled T2DM patients.</p><p><strong>Results: </strong>The study was conducted from July 2017 to December 2020 and enrolled 31 patients for the Digma System Endoscopic procedure. The Dose Escalation Cohort (DEC) used sub-therapeutic laser doses for training and safety. The Treatment Cohort (TC) of 25 patients received therapeutic doses, resulting in HbA1c reductions of -0.6% at 6 months (p = 0.014) and -0.4% at 12 months (p = 0.062). Fasting glucose dropped 17.3 mg/dL (p = 0.173) at 6 months and 28 mg/dL (p = 0.022) at 12 months. Post-prandial glucose improvements were also observed. HOMA-IR improved at 3 and 6 months. PAGI-SYM and PAGI-QOL showed stable to slightly improved GI symptoms and quality of life. Two severe adverse events were unrelated to the procedure.</p><p><strong>Conclusion: </strong>The study demonstrates the safety, feasibility, and potential efficacy of the Digma System Endoscopic procedure. Evidence suggests improvements in HbA1c, fasting and post-prandial glucose, and HOMA-IR levels could be attributed to the Digma System Endoscopic procedure.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"750-758"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leishmaniasis in IBD Patients: Challenges of a Rare Opportunistic Disease.","authors":"Candida Abreu, Rafael Rocha","doi":"10.1002/ueg2.12753","DOIUrl":"10.1002/ueg2.12753","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"665-666"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI Volumetric Changes in Perianal Fistulizing Crohn's Disease: Moving Toward a Novel Outcome Measure for Therapeutic Response.","authors":"Raja Atreya, Markus F Neurath","doi":"10.1002/ueg2.12765","DOIUrl":"10.1002/ueg2.12765","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"667-668"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Insights Into the Educational and Career Impact of Pediatric-Onset IBD.","authors":"Yize Ying, Wensheng Pan","doi":"10.1002/ueg2.70016","DOIUrl":"10.1002/ueg2.70016","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"841-842"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Autoimmune Pancreatitis: Clinical Findings and Outcomes in Sweden.","authors":"Miroslav Vujasinovic, Fredrik Lindgren, Nikolaos Kartalis, Raffaella Pozzi Mucelli, Dawid Rutkowski, Alexander Waldthaler, Poya Ghorbani, Carlos Fernández Moro, Thomas Casswall, J-Matthias Löhr","doi":"10.1002/ueg2.70022","DOIUrl":"10.1002/ueg2.70022","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric autoimmune pancreatitis (AIP) is a rare form of pancreatitis in children with poorly understood pathophysiology. It is a recognized risk factor for chronic pancreatitis in approximately 4% of pediatric cases. This study aims to describe the demographics, clinical characteristics, and outcomes of a large Swedish cohort of pediatric AIP patients.</p><p><strong>Patients and methods: </strong>A retrospective analysis of medical records was conducted for patients diagnosed with pediatric AIP between January 2006 and December 2022.</p><p><strong>Results: </strong>Thirty-seven patients were included (20 males, 17 females; mean age 13.5 ± 2.8 years). None had a family history of pancreatic diseases. Most patients (62.2%) presented with acute pancreatitis, followed by weight loss (45.9%), abdominal pain (43.2%), jaundice (21.6%), and fatigue (16.2%). Acute pancreatitis was mild in all cases according to the Atlanta criteria. Multi-organ involvement was observed in 81.1% of patients, and inflammatory bowel disease (IBD) was present in 62.2%. A total of 75.7% of patients received treatment, mainly glucocorticoids, while 24.3% had spontaneous regression. Complete clinical and radiological remission was achieved in 83.8% of treated patients. Pancreatic exocrine insufficiency was present in 43.2% of patients at diagnosis, reducing to 24.3% at the final follow-up. No patients developed diabetes mellitus, except for one who underwent total pancreatectomy due to suspected pancreatic tumor.</p><p><strong>Conclusions: </strong>Pediatric AIP is a rare condition often associated with multi-organ involvement particularly IBD. Most patients respond well to glucocorticoid treatment and achieve remission. Managing IBD may improve the outcomes for both conditions.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"819-830"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Completely Right-Sided Sigmoid and Descending Colon in a Rectal Cancer Patient.","authors":"Rui Hou, Guole Lin","doi":"10.1002/ueg2.12754","DOIUrl":"10.1002/ueg2.12754","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"834-835"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Interaction With Advanced Therapies in Inflammatory Bowel Diseases: A Blind Spot to Tackle.","authors":"Nathan Grellier, Julien Kirchgesner","doi":"10.1002/ueg2.12750","DOIUrl":"10.1002/ueg2.12750","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"663-664"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite Lymphoma: A Rare Case of Vomiting.","authors":"Changqin Liu, Dongyan Han, Xiaomin Sun","doi":"10.1002/ueg2.12768","DOIUrl":"10.1002/ueg2.12768","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"836-839"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Concomitant Precipitating Factors of Hepatic Encephalopathy Are Associated With a Poor Prognosis in Patients With Cirrhosis Admitted to Intensive Care Unit.","authors":"Marika Rudler, Marie de Matharel, Charlotte Bouzbib, Sarah Mouri, Lyes Kheloufi, Nicolas Weiss, Philippe Sultanik, Dominique Thabut","doi":"10.1002/ueg2.12706","DOIUrl":"10.1002/ueg2.12706","url":null,"abstract":"<p><strong>Introduction: </strong>Management of hepatic encephalopathy relies on the identification and control of precipitating factors (PF). The prognostic value of a PF is unknown, which we aimed to explore.</p><p><strong>Patients and methods: </strong>Single-center retrospective study of cirrhotic patients included in a prospective cohort admitted to an intensive care unit (ICU) between 2019 and 2022.</p><p><strong>Inclusion criteria: </strong>cirrhosis; overt hepatic encephalopathy; ammonemia ≥ 50 μmol/L. PF considered: gastrointestinal bleeding, infection, acute renal injury (AKI), hyponatremia, constipation, non-adherence to ammonia-lowering therapy, TIPS, drugs precipitating overt hepatic encephalopathy. The primary endpoint was 1-year transplant-free survival (TFS). Secondary endpoint was recurrence of hepatic encephalopathy.</p><p><strong>Results: </strong>179/497 patients were included (men 72%, age 59, cause of cirrhosis alcohol (ALD)/metALD/MASLD/other in 41/21/6/32%, Child-Pugh A/B/C in 1/18/81%, West Haven grade 2/3/4 in 63/15/22%, MELD score 23). Reasons for admission were: gastrointestinal bleeding (31%), acute encephalopathy (28%), worsening liver function/jaundice (25%), infection (8%), and AKI (8%). All patients (100%) had at least one PF of hepatic encephalopathy (infection [64%], AKI [63%], drugs [41%], bleeding [36%], hyponatremia [22%], TIPS [12%], and constipation [1%]), and 82% had multiple concomitant PF. In-hospital mortality was 50%, and median TFS was 0.8 months. In multivariate analysis, factors associated with death or liver transplantation were the number of PF, MELD and Child-Pugh scores, ACLF, AKI and infection. Hepatic encephalopathy reoccurred in 42% (median delay of 30 months).</p><p><strong>Conclusion: </strong>All patients had precipitating factor of hepatic encephalopathy, 82% of them having multiple concomitant precipitating factors. Concomitant multiple precipitating factors were associated with death or liver transplantation. A systematic screening for all precipitating factors of hepatic encephalopathy should be proposed for cirrhotics admitted to intensive care unit.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"738-749"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}