JGH Open最新文献

{"title":"Comparison of early versus late addition of granulocyte and monocyte adsorption for incomplete remission induction in ulcerative colitis","authors":"Keiichi Tominaga,&nbsp;Mimari Kanazawa,&nbsp;Shoko Watanabe,&nbsp;Takanao Tanaka,&nbsp;Shunsuke Kojimahara,&nbsp;Satoshi Masuyama,&nbsp;Keiichiro Abe,&nbsp;Akira Kanamori,&nbsp;Akira Yamamiya,&nbsp;Takeshi Sugaya,&nbsp;Kenichi Goda,&nbsp;Yuji Fujita,&nbsp;Shigemi Yoshihara,&nbsp;Yasuo Haruyama,&nbsp;Atsushi Irisawa","doi":"10.1002/jgh3.70012","DOIUrl":"10.1002/jgh3.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and aim</h3>\u0000 \u0000 <p>Ulcerative colitis (UC) is characterized by repeated relapse and remission. Because no fundamental therapeutic strategy has been established, the treatment goal is generally to maintain the remission phase for a long period after rapid remission induction. Granulocyte and monocyte adsorption (GMA) for UC is reportedly quite safe because it does not affect immunosuppression. Moreover, it is useful in combination with other remission induction therapy. The aim of this study was to evaluate the difference in efficacy by the timing of the addition of GMA with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy for active UC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 59 patients. Patients who started GMA of 5–11 days were in the early GMA combination group. Patients who started GMA 12 days or more were in the late GMA combination group. The primary endpoint was difference in the effect of additional GMA according to the timing of the intervention. The secondary endpoint was difference in the time to remission induction between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 32 early GMA group patients, 24 achieved remission induction. Of the 27 late group patients, 18 achieved remission induction. No significant difference in induction rates was found (<i>P</i> = 0.481). The early group had shorter mean time to remission induction (<i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, results suggest that early addition of GMA might lead to earlier remission in patients who have had an inadequate response to remission induction therapy with corticosteroids, calcineurin inhibitors, and anti-cytokine therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761597","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":"Risk factors for clinical relapse in patients with ulcerative colitis who are in clinical remission but with endoscopic activity","authors":"Ryosuke Horio,&nbsp;Jun Kato,&nbsp;Yuki Ohta,&nbsp;Takashi Taida,&nbsp;Keiko Saito,&nbsp;Miyuki Iwasaki,&nbsp;Yusuke Ozeki,&nbsp;Yushi Koshibu,&nbsp;Nobuaki Shu,&nbsp;Makoto Furuya,&nbsp;Yuhei Oyama,&nbsp;Hayato Nakazawa,&nbsp;Yukiyo Mamiya,&nbsp;Chihiro Goto,&nbsp;Satsuki Takahashi,&nbsp;Akane Kurosugi,&nbsp;Michiko Sonoda,&nbsp;Tatsuya Kaneko,&nbsp;Naoki Akizue,&nbsp;Kenichiro Okimoto,&nbsp;Tomoaki Matsumura,&nbsp;Naoya Kato","doi":"10.1002/jgh3.70011","DOIUrl":"10.1002/jgh3.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>The treatment strategy for patients with ulcerative colitis (UC) in clinical remission who have not achieved mucosal healing is unclear. This study aimed to determine the risk factors of relapse in patients in clinical remission with endoscopic activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, single-center study included patients with UC who underwent colonoscopy (CS) and were in clinical remission with endoscopic activity. Characteristics were compared between patients who relapsed within 2 years after CS and those who did not. A Cox proportional hazards regression model was used to identify risk factors contributing to clinical relapse. Recent worsening in bowel symptoms was defined as increase in bowel frequency and/or increase in abdominal pain within approximately 1 month based on the descriptions in the medical charts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study regarded 142 patients in clinical remission with an endoscopic activity of Mayo endoscopic subscore (MES) of ≥1 as eligible, and 33 (23%) patients relapsed during the observation period. Recent worsening of bowel symptoms was a significant risk factor for clinical relapse (hazard ratio [HR]: 3.02, 95% confidence interval [CI]: 1.34–6.84). This was particularly evident in patients with MES of 2 (HR: 5.16, 95% CI: 1.48–18.04), whereas no risk factors were identified in patients with MES of 1. The presence or absence of therapeutic intervention just after CS did not significantly affect clinical relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recent worsening in bowel symptoms was a significant risk factor for clinical relapse in patients with UC who were in clinical remission with endoscopic activity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761599","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":"Australians with metabolic dysfunction-associated steatotic liver disease have a twofold increase in the incidence of cancer","authors":"Elizabeth E Powell,&nbsp;Shruti Roche,&nbsp;Babak Sarraf,&nbsp;Gunter Hartel,&nbsp;Richard Skoien,&nbsp;Barbara Leggett,&nbsp;James O'Beirne,&nbsp;Patricia C Valery","doi":"10.1002/jgh3.70000","DOIUrl":"10.1002/jgh3.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with an increased risk of extrahepatic morbidity. We compared the incidence of cancers in adults admitted to Queensland hospitals with MASLD with that for the Queensland population and examined the association between cirrhosis and type 2 diabetes and the development of extrahepatic cancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, we identified all cancers (Queensland Cancer Registry) after the first hospitalization with MASLD during Jul-2007 to Dec-2019, estimated age-standardized incidence (ASI) of cancers, and compared that with the ASI in the Queensland population (incidence rate ratios [IRR]). Among the MASLD cohort, we examined the association between diabetes and cancer risk (Cox regression). Median follow-up was 3.8 years (54 204 person-years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Totally 1104 new cancers were diagnosed in 1018 patients (8.9% of 9771 non-cirrhotic and 1712 adults with cirrhosis). The ASI (all cancers) of 1668.2 per 100 000 person-years in men (95% CI 1523.7–1827.4) and 1284.0 per 100 000 person-years in women (95% CI 1169.6–1408.2) was 2-fold higher than that of the Queensland population (IRR = 1.94, 95% CI 1.75–2.16 and IRR = 1.99, 95% CI 1.78–2.22, respectively). Incidence of stomach cancer, unknown primary, and pancreas was 3- to 5-fold higher compared to the general population (all <i>P</i> &lt; 0.001). In multivariable analysis of the MASLD cohort, older age (e.g. ≥70 years adjusted hazard ratio [adj-HR] = 4.59, 95% CI 3.61–5.83), male gender (adj-HR = 1.20, 95% CI 1.05–1.37), and cirrhosis (adj-HR = 1.37, 95% CI 1.11–1.70) were independently associated with extrahepatic cancer risk, while diabetes was not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings will help to raise awareness among clinicians about the importance of cancer vigilance in this patient group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749235","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":"Spray coagulation reduces the use of hemostatic forceps for intraoperative bleeding in gastric endoscopic submucosal dissection","authors":"Yumiko Ishikawa,&nbsp;Osamu Goto,&nbsp;Shun Nakagome,&nbsp;Tsugumi Habu,&nbsp;Kumiko Kirita,&nbsp;Eriko Koizumi,&nbsp;Kazutoshi Higuchi,&nbsp;Hiroto Noda,&nbsp;Takeshi Onda,&nbsp;Jun Omori,&nbsp;Naohiko Akimoto,&nbsp;Katsuhiko Iwakiri","doi":"10.1002/jgh3.70002","DOIUrl":"https://doi.org/10.1002/jgh3.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>During intraoperative bleeding in endoscopic submucosal dissection (ESD), switching to spray coagulation may be beneficial compared with the continuous use of swift coagulation and can reduce the need for hemostatic forceps. We retrospectively assessed the effectiveness of spray modes on intraoperative bleeding during gastric ESD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A total of 316 bleeding events (156 in the Swift group and 160 in the Spray group) were consecutively recorded. In the Swift group, hemostasis was performed using the swift mode with a retracted tip of the needle-type knife, followed by the hemostatic forceps. In the Spray group, bleeding was treated in a stepwise manner: the swift mode, the spray mode, and the hemostatic forceps. All bleeding events were assigned to one of two groups by an endoscopist who retrospectively reviewed the videos. We compared the use of hemostatic forceps, the total hemostatic time, and the cumulative hemostasis rate between the two groups.</p>\u0000 \u0000 <p>The use of hemostatic forceps was significantly lower in the Spray group than in the Swift group (32.7% vs. 13.8%, <i>P</i> &lt; 0.001). There was no significant difference in the total hemostatic time (Swift group, 20 s.; Spray group, 16 s.; <i>P</i> = 0.42), whereas the cumulative hemostasis rate with the knife was significantly higher in the Spray group (<i>P</i> = 0.007).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results suggested that spray coagulation from the tip of the needle-type knife could reduce the use of hemostatic forceps. In gastric ESD, spray coagulation may facilitate the hemostasis of intraoperative bleeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730350","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":"Rare case of rectal carcinoid with synchronous primary carcinoid tumors of the lung misdiagnosed as lung metastases","authors":"Fuminori Teraishi,&nbsp;Rhohei Shoji,&nbsp;Toshiyoshi Fujiwara","doi":"10.1002/jgh3.70003","DOIUrl":"https://doi.org/10.1002/jgh3.70003","url":null,"abstract":"<p>A 68-year-old woman was referred to our hospital for rectal surgery after a pathological diagnosis of rectal carcinoid with venous invasion following endoscopic submucosal dissection of a 5 mm-sized submucosal tumor in the lower rectum. Chest CT showed nodules in the left upper lobe and right lower lobe, but positron emission tomography and somatostatin receptor scintigraphy showed no hyperaccumulation in the lung nodules. CT-guided needle biopsy was performed on the nodular lesion in the left upper lobe, which showed focal growth of tumor cells with a high N/C ratio and positive synaptophysin, leading to a diagnosis of pulmonary metastasis of rectal carcinoid. Since the patient was asymptomatic and did not wish to undergo surgery or chemotherapy, she was followed up strictly with sufficient informed consent. Three years have passed since the diagnosis, and there is no tendency for the lung metastasis to increase, and no other new lesions have been observed. The disease had not progressed and remained stable. Therefore, immunohistological analysis of the lung biopsy specimen was performed again, which was positive for TTF-1 and negative for CDX2. Consequently, the diagnosis was changed to primary lung carcinoid tumors, and the patient remains under follow-up with no disease progression.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730349","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":"Innovative concepts in diet therapies in disorders of gut–brain interaction","authors":"Daniel So,&nbsp;Caroline Tuck","doi":"10.1002/jgh3.70001","DOIUrl":"10.1002/jgh3.70001","url":null,"abstract":"<p>Diet therapy in disorders of gut–brain interaction (DGBI) is rapidly advancing, with accumulating evidence to support two innovative therapies—manipulation of dietary fibers and enzyme supplementation—that target specific DGBI pathophysiology and modulate digestion. Dietary fibers escape digestion in the upper gastrointestinal tract and can influence gut function by impacting digestion, improving laxation, and interacting with the microbiota. A more nuanced understanding of different fiber types and their ability to impact gut function in highly specific ways has shown that fibers can impact distinct gut symptoms and pathophysiology. By considering their functional characteristics of bulking, gel-forming, and fermentability, restriction or supplementation of specific fibers can offer clinical value in DGBI. Similarly to fiber specificity, emerging evidence suggests that supplemental digestive enzymes may be targeted to known food triggers with consideration that enzymes are substrate specific. Limited evidence supports use of lactase to target lactose, and α-galactosidase to target galacto-oligosaccharides. Application of enzymes during manufacturing of food products may prove to be an additional strategy, although evidence is scant. Both innovative therapies may be utilized in isolation or in combination with other diet and nondiet therapies. Implementation can be guided by the principles that fiber modulation can be targeted to specific symptomology or requirement for alterations to gut function, and digestive enzymes can be targeted to known food triggers. This review aims to summarize recent literature of these two innovative concepts and provide practical suggestions for their implementation in clinical practice.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11255864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724710","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":"Associations between diet and nutritional supplements and colorectal cancer: A systematic review","authors":"Maryam Gholamalizadeh,&nbsp;Shirin Tajadod,&nbsp;Nazanin Majidi,&nbsp;Zohreh Aghakhaninejad,&nbsp;Zahra Mahmoudi,&nbsp;Zahra Mousavi,&nbsp;Arezoo Amjadi,&nbsp;Farkhondeh Alami,&nbsp;Mahdie Torkaman,&nbsp;Zahra Saeedirad,&nbsp;Saeid Doaei,&nbsp;Hanieh Shafaei,&nbsp;Naser Kalantari","doi":"10.1002/jgh3.13108","DOIUrl":"10.1002/jgh3.13108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Colorectal cancer (CRC) is one of the most prevalent cancers around the world. The link between nutrients and the likelihood of developing CRC remains uncertain. The primary objective of the present study was to investigate the potential connection between dietary intake/dietary supplements and the occurrence of CRC through a literature review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive online search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library from January 1990 to March 2023 using appropriate keywords. A systematic search was conducted for clinical trials and cohort studies in order to determine the relationship between dietary components/supplements and CRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intake of long-chain n-3 polyunsaturated fatty acids (n-3 LCPUFAs), consisting of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has the potential to decrease the likelihood of developing CRC (eight studies found positive effects and four studies found no association). Some other dietary components such as probiotics, prebiotics, and synbiotics may contribute to suppressing CRC development (three studies found positive effects, whereas three studies did not find any association). There is inconclusive evidence that supplementation with certain micronutrients including vitamin D (one trial found positive effects and another trial reported no association), folate, zinc, and selenium may reduce the risk of CRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Some dietary supplements such as n-3 LCPUFAs and probiotics have the potential to reduce the risk of developing CRC. Further studies are necessary to validate these results and understand the underlying mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11256152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724709","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":"Human-induced pluripotent stem cell-derived hepatocyte platform in modeling of SARS-CoV-2 infection","authors":"Ruiqi Zhang,&nbsp;Rui Wei,&nbsp;Yangyang Yuan,&nbsp;Na Li,&nbsp;Yang Hu,&nbsp;Kwok-Hung Chan,&nbsp;Ivan Fan-Ngai Hung,&nbsp;Hung-Fat Tse","doi":"10.1002/jgh3.13039","DOIUrl":"https://doi.org/10.1002/jgh3.13039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Currently, SARS-CoV-2 is still spreading rapidly and globally. A large proportion of patients with COVID-19 developed liver injuries. The human-induced pluripotent stem cell (iPSC)-derived hepatocytes recapitulate primary human hepatocytes and have been widely used in studies of liver diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To explore the susceptibility of hepatocytes to SARS-CoV-2, we differentiated iPSCs to functional hepatocytes and tried infecting them with different MOI (1, 0.1, 0.01) of SARS-CoV-2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The iPSC-derived hepatocytes are highly susceptible to virus infection, even at 0.01 MOI. Other than the ancestral strain, iHeps also support the replication of SARS-CoV-2 variants including alpha, beta, theta, and delta. More interestingly, the ACE2 expression significantly upregulated after infection, suggesting a vicious cycle between virus infection and liver injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The iPSC-derived hepatocytes can support the replication of SARS-CoV-2, and this platform could be used to investigate the SARS-CoV-2 hepatotropism and hepatic pathogenic mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.13039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607999","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":"When organs collide: A rare cause of gastrointestinal bleeding","authors":"Darragh Egan,&nbsp;Rohita Reji,&nbsp;Tim Mitchell","doi":"10.1002/jgh3.13105","DOIUrl":"https://doi.org/10.1002/jgh3.13105","url":null,"abstract":"<p>A 72-year-old man was referred to our Emergency Department with a 2-week history of melaena. His medical history was relevant for Atrial Fibrillation and Non-Hodgkin's Lymphoma (NHL) in remission on most recent PET. Our patient responded to resuscitative management and then went on to have upper gastrointestinal endoscopic evaluation to elucidate the cause of bleeding. As seen in the images, endoscopy showed a gross defect in fundal wall with evidence of extrinsic infiltration by a large vascular mass-like structure, suspected to be spleen. Computed tomography (CT) abdomen and pelvis confirmed a gastrosplenic fistula as well as new lymphadenopathy. The findings were in keeping with recurrence of NHL. Discussion at multidisciplinary meeting deemed his gastrosplenic fistula unsuitable for surgical repair. He was managed conservatively, had a nasojejunal (NJ) tube inserted for feeding, and clinically improved on the ward. Our patient expressed a preference not to undergo further chemotherapy, having struggled quite significantly with his initial chemotherapy. He was discharged home 23 days following admission. At this stage, his NJ tube was removed and he was tolerating oral diet. He is currently being managed by the Palliative Care team in the community.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.13105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607998","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":"Long-term posttransplant survival outcome following bridging locoregional therapy in hepatocellular carcinoma patients: A systematic review and meta-analysis","authors":"Alan Chuncharunee,&nbsp;Songporn Oranratnachai,&nbsp;Lancharat Chuncharunee,&nbsp;Pongphob Intaraprasong,&nbsp;Ammarin Thakkinstian,&nbsp;Abhasnee Sobhonslidsuk","doi":"10.1002/jgh3.13111","DOIUrl":"10.1002/jgh3.13111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Liver transplantation (LT) is essential due to its curative efficacy, but liver-graft shortages have limited its widespread application. Bridging locoregional therapy (LRT) before LT has been performed to prevent tumor progression, and a recent literature review revealed that it is associated with a nonsignificant trend toward better survival outcomes. However, much more information on bridging therapy has become available since then. This meta-analysis aimed to compare the posttransplant survival and HCC recurrence between patients with and without pretransplant bridging LRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies were identified in MEDLINE, SCOPUS, and the Cochrane Library. Two independent researchers screened titles and full articles, extracted relevant data, and conducted a parametric survival analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 4794 studies, 18 cohort studies were eligible. The 1-, 3-, and 5-year overall survival (OS) rates were 93.1%, 85.0%, and 79.1% for those in the bridging LRT group, while they were 91.8%, 81.1%, and 75.5% for those who did not receive LRT, respectively. There were no differences in overall survival between these groups (HR 0.90; 0.78–1.05, P = 0.17). Interestingly, we discovered that bridging therapy helped prolong survival significantly in a high-risk population with a long waiting time (HR 0.76; 0.60–0.96, P = 0.02). Unfortunately, bridging LRT did not improve disease-free survival (HR 0.98; 0.86–1.11, P = 0.70).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results indicate that bridging LRT does not generally change post-LT outcomes. However, bridging LRT can significantly improve survival in patients with a long waiting time for LT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560026","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}