Gastroenterology Insights最新文献

{"title":"Association Analysis of Genetic Variants of Sodium Taurocholate Co-Transporting Polypeptide NTCP Gene (SLC10A1) and HBV Infection Status in a Cohort of Egyptian Patients","authors":"M. El Raziky, N. Zayed, Y. Ibrahim, Fatma Elrashdy, R. M. Shahin, M. Hassany, M. El Serafy, W. Doss, V. Uversky, A. Yosry, H. G. Eldeen","doi":"10.20944/preprints202107.0585.v1","DOIUrl":"https://doi.org/10.20944/preprints202107.0585.v1","url":null,"abstract":"Background: Single nucleotide polymorphisms (SNPs) in the SLC10A1 gene, coding for a functional receptor of hepatitis B virus (HBV), sodium taurocholate co-transporting polypeptide (NTCP), may influence the susceptibility, the outcome, and disease course of HBV infection in some populations. Aim: to determine the prevalence of SNPs of NTCP gene, rs2296651 and rs943277, and their relationship with chronic HBV infection in a group of Egyptian patients. Methods: 137 patients with HBV and 65 healthy controls were enrolled, and the patients were divided into two groups; group I chronic HBV infection (68 patients with normal ALT and minimal or no liver necroinflammation or fibrosis) and group II chronic hepatitis B (69 patients with elevated ALT and moderate or severe liver necroinflammation). They were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound, and liver stiffness measurement using both Echosens® Fibroscan and acoustic radiation force impulse (ARFI). Real time PCR TaqMan 5’ allelic discrimination assay was applied to detect the SNPs in NTCP gene, rs2296651 and rs943277. Results: On studying the rs2296651 variant, all controls and patients had genotype GG without any significant association with HBV infection or disease progression. However, the rs943277 variant in all controls and 98% of patients had genotype GA, except for two chronic HBV infection patients who had genotype AA, but no significant difference between patients and controls was found. The non-invasive methods for liver fibrosis assessment ARFI, AST/platelet's ratio (APRI), and fibrosis-4 score (FIB-4) could predict the stages of fibrosis in agreement with Fibroscan with AUCOR 0.8, 0.79, and 0.76, respectively. Conclusion: These findings may suggest that there is no relation between these SNPs of the NTCP gene and susceptibility or chronicity of HBV infection in the Egyptian population. We also suggest that the use of the non-invasive methods for liver fibrosis assessment, ARFI, FIB-4, and APRI may decrease the need for liver biopsies in prediction of significant hepatic fibrosis in chronic HBV patients.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45396848","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":"Effectiveness of Direct-Acting Antivirals in Treatment of Elderly Egyptian Chronic Hepatitis C Patients","authors":"Shimaa Y. Kamel, Hagar Elessawy, Ossama Ashraf, Ahmed A. El-Baz, H. Dabbous, M. El-Sayed, S. Ali, Heba Y Kamel","doi":"10.3390/GASTROENT12030031","DOIUrl":"https://doi.org/10.3390/GASTROENT12030031","url":null,"abstract":"Background: Hepatitis C virus treatment has dramatically improved by direct-acting antiviral (DAA) therapy. The aim of this study was to assess the efficacy and safety of DAA in elderly Egyptian chronic hepatitis C (CHC) patients. Methods: The study was carried out on 327 CHC elderly patients >60 years; patients were divided into 3 age subgroups (<65, 65–75 and >75 years) on DAA therapy for 12 weeks. Ninety-one patients (27.8%) were treated with dual therapy, 234 patients (71.6%) with triple therapy and 2 patients (0.6%) with quadrable therapy. Results: All patients achieved end-of-treatment virological response (100%). ALT levels normalized during therapy. The follow-up rate of sustained virological response at 12 weeks after the end of treatment (SVR12) was 100%. One hundred and two patients had missed SVR12 data due to being lost tofollow-up. Two hundred twenty-two adverse events were reported (67.8%), including anemia in 30 patients (9.1%), leucopenia in 129 patients (39.4%) and thrombocytopenia in 63 patients (19.2%). No serious side effects led to discontinuation of therapy. No hepatic decompensation was observed, and no patients died. Conclusion: Age does not influence the success of DAA treatment and all DAA regimens are well tolerated, safe and highly efficacious, even in those aged 75 years or older.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/GASTROENT12030031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48455833","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":"What Is the Correct Way to Manage Children Requiring Gastrostomy? Single Center Experience","authors":"C. Noviello, M. Romano, E. Bindi, G. Cobellis, S. Nobile, A. Papparella","doi":"10.3390/GASTROENT12030030","DOIUrl":"https://doi.org/10.3390/GASTROENT12030030","url":null,"abstract":"Children with complex medical issues often present different comorbidities that cause feeding difficulties. Gastrostomy is often helpful, and should be performed when nutritional supplementation is necessary for longer than 6 weeks. Recently, different techniques have been used for gastrostomy in children. The authors report on their experiences regarding the diagnostic and therapeutic management of children requiring gastrostomy. All patients managed in the last 10 years were reviewed, retrospectively. Everyone underwent investigation to exclude gastroesophageal reflux disease (GERD). A total of 148 patients: 111 cases (75%) were neurologically impaired patients, 18 (12%) had complex heart disease, 10 (6%) had metabolic diseases, 4 (3%) had fibrosis cystic, 4 (3%) had muscle disease, and one had chromosomopathy. After investigation, 49 patients had GERD. PEG was performed in 101 cases (68%), laparo-assisted gastrostomy was performed in 44 cases (29.7%), open gastrostomy was performed in three cases. At follow-up, all patients reported weight gain, but 13 cases had major complications. Currently, the surgeon has the possibility of choosing between several safe techniques for gastrostomy. In our experience, PEG is the most useful technique for patients without GERD, while a laparo-assisted technique is better for patients who require laparoscopic fundoplication.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/GASTROENT12030030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47263817","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":"A Case Report of a Colorectal and Caudal Duplication Syndrome Associated with Caudal Regression Syndrome","authors":"D. Iozsa, A. Tulin, I. Slavu, M. Ivanov, V. Constantin, Dragos Eugen Ionescu, R. Tulin, B. Socea","doi":"10.3390/GASTROENT12030029","DOIUrl":"https://doi.org/10.3390/GASTROENT12030029","url":null,"abstract":"We describe an uncommon clinical presentation of caudal duplication syndrome and features of caudal regression syndrome in a female infant with complex urogenital and colorectal duplication associated with lipomyleomeningocele and left lower limb hypoplasia. A staged surgical treatment plan was carried out to maintain fecal and urine continence, potential fertility, and cosmetic appearance.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/GASTROENT12030029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47832093","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":"Surgical Techniques for Rectal Prolapse","authors":"S. Leventoğlu, B. Menteş, B. Balci, A. Yildiz","doi":"10.3390/GASTROENT12030028","DOIUrl":"https://doi.org/10.3390/GASTROENT12030028","url":null,"abstract":"Complete rectal prolapse or rectal procidentia is a debilitating disease that presents with fecal incontinence, constipation, and rectal discharge. Definitive surgical techniques described for this disease include perineal procedures such as mucosectomy and rectosigmoidectomy, and abdominal procedures such as rectopexy with or without mesh and concomitant resection. The debate over these techniques regarding the lowest recurrence and morbidity rates, and the best functional outcomes for constipation or incontinence, has been going on for decades. The heterogeneity of available studies does not allow us to draw firm conclusions. This article aims to review the surgical techniques for complete rectal prolapse based on the current evidence base regarding surgical and functional outcomes.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45590810","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":"Neuropathic Pain in Pancreatic Cancer: An Update of the Last Five Years","authors":"R. Pezzilli","doi":"10.3390/gastroent12030027","DOIUrl":"https://doi.org/10.3390/gastroent12030027","url":null,"abstract":"Pain is the main symptom of pancreatic cancer (pancreatic ductal adenocarcinoma, PDAC). Pain in pancreatic cancer may be visceral, somatic or neuropathic in origin. Pain is produced by tissue damage, inflammation, ductal obstruction and infiltration. Visceral nociceptive signals caused by damage to the upper abdominal viscera are carried along sympathetic fibers, which travel to the celiac plexus nerves and ganglia, which are found at the T12-L2 vertebral levels, anterolateral to the aorta near the celiac trunk. From here, the signals are transmitted through the splanchnic nerves to the T5-T12 dorsal root ganglia and then on to the higher centers of the central nervous system. Somatic and neuropathic pain may arise from tumor extension into the surrounding peritoneum, retroperitoneum and bones and, in the latter case, into the nerves, such as the lumbosacral plexus. It should also be noted that other types of pain might arise because of therapeutic interventions, such as post-chemoradiation syndromes, which cause mucositis and enteritis. Management with non-steroidal anti-inflammatory agents and narcotics was the mainstay of therapy. In recent years, celiac plexus blocks and neurolysis, as well as intrathecal therapies have been used to control severe pain, at times resulting in a decreased need for drugs, avoiding their unwanted side effects. Pain may impair the patient’s quality of life, negatively affecting patient outcome and resulting in increased psychological stress. Even after recognizing the negative effect of cancer pain on patient overall health, studies have shown that cancer pain is still undertreated. This review focuses on neuropathic pain, which is difficult to handle; thus, the most recent literature was reviewed in order to diagnose neuropathic pain and its management.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/gastroent12030027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46699145","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":"Biosimilar Interchangeability and Emerging Treatment Strategies for Inflammatory Bowel Diseases: A Commentary","authors":"R. Parrish","doi":"10.3390/gastroent12030026","DOIUrl":"https://doi.org/10.3390/gastroent12030026","url":null,"abstract":"This commentary summarizes a collection of key references published within the last ten years, and identifies pharmacologic research directions to improve treatment access and success through greater biosimilar or “follow-on” biologic utilization combined with other targeted small molecule agents that possess unique pathophysiologic mechanisms for inflammatory bowel diseases (IBD) in adult and pediatric patients. Since they are not identical to the originator or reference biologic agent, all biosimilars are not generically equivalent. However, in the US and other countries, they are considered therapeutically interchangeable if the manufacturer has demonstrated no clinically meaningful differences from the reference product. Comparisons of different clinical initiation and switching scenarios are discussed with reference to interchangeability, immunogenicity, nocebo effect, cost effectiveness, and time courses for discontinuation rates.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":"28 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/gastroent12030026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41255608","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":"Foremost Concepts in Mechanisms of De Novo Post-Liver Transplantation Malignancy","authors":"M. Peruhova, Monika Peshevska-Sekulovska, Gabriela Panayotova, T. Velikova","doi":"10.3390/gastroent12030025","DOIUrl":"https://doi.org/10.3390/gastroent12030025","url":null,"abstract":"In liver transplant patients, solid tumors and post-transplant lymphoproliferative disorders (PTLD) have emerged as significant long-term mortality causes. Additionally, it is assumed that de novo malignancy (DNM) after liver transplantation (LT) is the second-leading cause of death after cardiovascular complications. Well-established risk factors for PTLD and solid tumors are calcineurin inhibitors (CNIs), tacrolimus (TAC), and cyclosporine, the cornerstones of all immunosuppressive (IS) therapies used after LT. The loss of immunocompetence facilitated by the host immune system due to prolonged IS therapy leads to cancer development, including in LT patients. Hindering DNA repair mechanisms, promoting tumor cell invasiveness, and hampering apoptosis are critical events in tumorigenesis and tumor growth in LT patients resulting from IS administration. This paper aims to overview the refined mechanisms of IS-induced tumorigenesis after LT and the loss of immunocompetence facilitated by the host immune system due to prolonged IS therapy. In addition, we also discuss in detail the mechanisms of action in different types of IS regimen used after LT, and their putative effect on DNM.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/gastroent12030025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48258702","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":"Peritoneal Tuberculosis Mimicking Ovarian Cancer: Gynecologic Ultrasound Evaluation with Histopathological Confirmation","authors":"F. Arezzo, Gerardo Cazzato, V. Loizzi, G. Ingravallo, L. Resta, G. Cormio","doi":"10.3390/GASTROENT12020024","DOIUrl":"https://doi.org/10.3390/GASTROENT12020024","url":null,"abstract":"Peritoneal tuberculosis (TBP) is a very rare condition, accounting for about 1–2% of all tuberculosis cases. The diagnosis of TBP can be easily mistaken for advanced ovarian cancer (AOC) or peritoneal carcinoma because of overlapping laboratory and clinical findings. We reported the ultrasound characteristics of a case of TBP in a 67-year-old woman who presented to our institute with a 1-month history of intermittent lower abdominal pain, fever, and asthenia. Overall, 20 biopsy-retrieved specimen histopathological features were suggestive of peritoneal tuberculosis. Gynecologic ultrasound revealed increased adnexa with multiple nodular formations spread across the surface, suggestive of caseous nodules. Although this is a rare occurrence, clinicians should consider TBP as a differential diagnosis of ovarian or peritoneal cancer.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/GASTROENT12020024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44772621","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":"Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients","authors":"V. Thong, H. Anh","doi":"10.3390/GASTROENT12020023","DOIUrl":"https://doi.org/10.3390/GASTROENT12020023","url":null,"abstract":"Background: Ascites and esophageal varices (EV) are the most common complications of portal hypertension, with an incidence of approximately 50%. Since effective preventive modalities have been established for variceal hemorrhage, early detection of EV is critical for primary prevention of bleeding. Serum-ascites albumin gradient (SAAG) can be considered an indirect parameter for the detection of EV and is useful in regions where there is a shortage of human and material resources to perform upper gastrointestinal endoscopy (UGE). The aim was to evaluate the role of serum-ascites albumin gradient (SAAG) in the prediction of esophageal varices (EV) in cirrhotic patients with ascites. Methods: All cirrhotic patients with ascites, identified by ultrasonography, who underwent measurement of SAAG, were included in this study. All patients underwent upper gastrointestinal endoscopy (UGE) for assessment of the presence and size of EV. Results: The study included 80 cirrhotic patients with ascites. The main causes of cirrhosis were alcohol intake (37.5%), hepatitis B virus (25.0%), and hepatitis C virus (15.0%). Patients with SAAG values > 1.75 g/dL demonstrated EV with a sensitivity and specificity of 78.4% and 83.3%, respectively. SAAG values > 1.8 g/dL were associated with the risk of large EV with AUC of 0.856, sensitivity of 88.24%, and specificity of 50.79%. The correlation coefficient (r) between SAAG and EV was 0.429, which was statistically significant (p < 0.001). Conclusions: Cirrhotic patients with SAAG values ≥ 1.8 have a higher risk of large EV. In particular, those with values > 1.9 who have higher possibility of bleeding must undergo upper GI endoscopy.","PeriodicalId":43586,"journal":{"name":"Gastroenterology Insights","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3390/GASTROENT12020023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45473332","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}