JGH Open最新文献

{"title":"Evaluating Disparities in COVID-19 Clinical Outcomes Among Patients With Cirrhosis in North America and Europe—An International Registry Study","authors":"Umar Hayat,&nbsp;Andrew M. Moon,&nbsp;Manesh K. Gangwani,&nbsp;Fariha Hasan,&nbsp;Thomas Marjot,&nbsp;A. Sidney Barritt IV,&nbsp;Wasique Mirza,&nbsp;Duane Deivert,&nbsp;Muhammad Aziz,&nbsp;Dushyant Singh Dahiya,&nbsp;Hassam Ali,&nbsp;Sumant Inamdar,&nbsp;Mauricio Garcia-Saenz-de-Sicilia","doi":"10.1002/jgh3.70064","DOIUrl":"https://doi.org/10.1002/jgh3.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with decompensated cirrhosis have a higher risk of hospitalization, ICU admission, and death from COVID-19. The impact of demographics on these outcomes remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SECURE-Liver and COVID-Hep databases were utilized to evaluate disparities in COVID-19 outcomes. Patients were stratified by North American and European cohorts. Bivariate and multivariable logistic regression was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 718 cirrhosis patients with COVID-19 were evaluated. In the North American cohort, Black patients had more comorbidities (CI: 1.86 vs. 1.83, <i>p</i> &lt; 0.01), higher rates of hospitalization (77% vs. 85%, p &lt; 0.01), ICU admission (27% vs. 40%, <i>p</i> = 0.05), and death (18% vs. 28%, <i>p</i> = 0.07). Hispanic patients had the lowest adverse outcome rates. In the European cohort, White patients had more comorbidities (CI; 1.63 vs. 1.31, <i>p</i> = 0.02), but non-White patients had higher hospitalization rates (82% vs. 67%, <i>p</i> = 0.01), ICU admissions (15% vs. 18%, <i>p</i> = 0.04), and lower mortality rates (28% vs. 34%, p = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Black patients in North America had higher hospitalization, ICU admission, and death rates. In the European subgroup, White patients had higher death rates than non-White patients. These disparities became statistically insignificant after adjusting for confounders, suggesting that non-liver-related comorbidities might increase the risk of adverse outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749352","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":"Safety and performance of the HYBRIDknife flex in a porcine model of esophageal endoscopic submucosal dissection: A pilot study","authors":"Christopher J L Khor,&nbsp;Katsuro Ichimasa,&nbsp;Stephen K K Tsao,&nbsp;Ulrich Biber,&nbsp;Yutaka Saito","doi":"10.1002/jgh3.70036","DOIUrl":"https://doi.org/10.1002/jgh3.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) is considered the best modality for achieving en bloc resection of larger neoplastic mucosal lesions in the upper and lower gastrointestinal (GI) tract. Multiple devices are available for ESD, and refinements continue to be made to develop devices that improve the safety and efficiency of performing ESD. Submucosal injection with viscous fluids like glycerol, which prolong submucosal expansion, could facilitate the procedure. We aimed to evaluate the safety and performance of the new Erbe HYBRIDknife® flex, which combines electrosurgical dissection with waterjet-assisted injection in a slim and flexible form factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a prospective animal study with six pigs, four endoscopists, each with 10–20 years of experience in ESD, performed 28 esophageal ESDs. One half was performed with physiological saline injectate, the other half with fructose-added glycerol. Various performance aspects were evaluated on a five-point scale [5 = best], including dissection properties, handling, and usability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No perforations or major bleeding occurred. All resections were performed en bloc, with one technical failure (3.6%, 1 of 28). Performance scores were similar for saline and glycerol (4.5 ± 0.31 vs. 4.5 ± 0.32, <i>P</i> = 0.36), as was dissection speed (13 ± 6.2 mm²/min vs. 15 ± 6.1 mm²/min, <i>P</i> = 0.22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We demonstrated that esophageal ESD can be performed safely and rapidly using HYBRIDknife flex, with excellent performance evaluation by the endoscopists. Combining this device with glycerol or saline is precise and effective for ESD, although experience could compensate for the theoretical disadvantage of using normal saline.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 12","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758076","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":"Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding","authors":"Yasuhiko Hamada,&nbsp;Hayato Nakagawa","doi":"10.1002/jgh3.70051","DOIUrl":"https://doi.org/10.1002/jgh3.70051","url":null,"abstract":"<p>A 65-year-old man with a history of chronic renal failure and ischemic heart disease who was receiving aspirin therapy was admitted for recurrent melena. Initial evaluation revealed severe anemia. Other than a diverticulum in the third part of the duodenum, the findings of upper and lower gastrointestinal endoscopies and computed tomography were unremarkable. Capsule endoscopy detected altered blood in the ileum; however, balloon-assisted enteroscopy found no definitive source of bleeding. Three years later, he presented with recurrent melena and hemorrhagic shock. Upper gastrointestinal endoscopy identified Dieulafoy's lesion within the duodenal diverticulum. Hemostasis was achieved using hemoclips. No recurrence of bleeding was observed during 4 years of follow-up. The findings from this case highlight the diagnostic and therapeutic challenges of managing obscure gastrointestinal bleeding due to Dieulafoy's lesion in a diverticulum in the third part of the duodenum. Duodenal diverticular bleeding should be included in the differential diagnoses for patients with obscure gastrointestinal bleeding.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737388","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":"Next-Generation Sequencing: An Advanced Diagnostic Tool for Detection of Pancreatic Disease/Disorder","authors":"Suvro Biswas,&nbsp;Shamima Afrose,&nbsp;Mohasana Akter Mita,&nbsp;Md. Robiul Hasan,&nbsp;Mst. Sharmin Sultana Shimu,&nbsp;Shahriar Zaman,&nbsp;Md. Abu Saleh","doi":"10.1002/jgh3.70061","DOIUrl":"https://doi.org/10.1002/jgh3.70061","url":null,"abstract":"<p>The pancreas is involved in digestion and glucose regulation in the human body. Given the recognized link between chronic pancreatitis and pancreatic cancer, addressing pancreatic disorders and pancreatic cancer is particularly challenging. This review aims to highlight the limitations of traditional methods in diagnosing pancreatic disorders and cancer and explore several next-generation sequencing (NGS) approaches as a promising alternative. There are distinct clinical symptoms that are shared by a number of clinical phenotypes of pancreatic illness induced by particular genetic mutations. Traditional diagnostic methods encompass computed tomography, magnetic resonance imaging, contrast-enhanced Doppler ultrasound, endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, transabdominal ultrasound, laparoscopy, and positron emission tomography have a prognostic ability of only 5% or less and a 5-year survival rate. Genetic sequencing can be employed as an alternative to conventional diagnostic techniques. Sanger sequencing and NGS are currently largely operated genome analysis, with no exception for pancreatic disease diagnosis. The NGS methods can sequence millions to billions of short DNA fragments, enabling enormous sample screening in a short amount of time with low-abundance detection, like in 0.1%–1% mutation prevalence declining approximate cost. Whole-genome sequencing, whole-exome sequencing, RNA sequencing, and single-cell NGS are a few NGS methods utilized to diagnose pancreatic disease. For both research and clinical applications, the NGS techniques can provide a precise diagnosis of pancreatic disorders in a short amount of time at a reasonable expenditure.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737389","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":"Validation of the Updated Alternate Fistula Risk Score for Prediction of Postoperative Pancreatic Fistula After Pancreatoduodenectomy","authors":"Yugal Limbu,&nbsp;Bidur Prasad Acharya,&nbsp;Sneha Raut,&nbsp;Sujan Regmee,&nbsp;Roshan Ghimire,&nbsp;Dhiresh Kumar Maharjan,&nbsp;Prabin Bikram Thapa","doi":"10.1002/jgh3.70053","DOIUrl":"https://doi.org/10.1002/jgh3.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Postoperative pancreatic fistula (POPF) remains a significant challenge following pancreatoduodenectomy (PD), contributing to morbidity and mortality. Various risk assessment models have been established to predict the likelihood of POPF. An updated alternate fistula risk score (ua-FRS) has been recently refined and validated within European cohorts. However, the validation of this score in South Asian cohorts remains relatively unexplored. This study aims to validate the applicability of ua-FRS for the prediction of POPF in patients undergoing PD in the South Asian population, particularly Nepal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional, observational study was conducted by a single team across three tertiary care centers in Kathmandu, Nepal from July 2021 to October 2023. A total of 98 patients were studied in terms of their sex, body mass index (BMI), diameter of the main pancreatic duct (MPD), pancreatic consistency, pathological site, and estimated blood loss. The accuracy of ua-FRS for the prediction of postoperative pancreatic fistula after pancreatoduodenectomy was evaluated using the receiver operative characteristics curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Univariate analysis revealed that sex, pancreatic gland texture, the diameter of the main pancreatic duct, the site of pathology, and BMI were statistically significant factors. However, in the multivariate analysis, only BMI and the diameter of the MPD retained their statistical significance, with <i>p</i>-values less than 0.005. The ua-FRS demonstrated high sensitivity and specificity in predicting postoperative pancreatic fistula, as evidenced by an area under the curve (AUC) of 0.802.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ua-FRS has validation in the context of the South Asian population to predict POPF following PD, offering a reliable tool to guide perioperative management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737532","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":"Endoscopic Full-Thickness Plication for the Treatment of Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis of Randomized Sham Controlled Trials","authors":"Muhammad Shahzil,&nbsp;Ammad Javaid Chaudhary,&nbsp;Ali Akram Qureshi,&nbsp;Fariha Hasan,&nbsp;Muhammad Saad Faisal,&nbsp;Abdullah Sohail,&nbsp;Muhammad Ali Khaqan,&nbsp;Taher Jamali,&nbsp;Muhammad Zarrar Khan,&nbsp;Eva Alsheik,&nbsp;Tobias Zuchelli","doi":"10.1002/jgh3.70056","DOIUrl":"https://doi.org/10.1002/jgh3.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Gastroesophageal reflux disease (GERD) affects approximately 20% of adults in the United States. Proton pump inhibitors are the first-line treatment but are associated with long-term side effects. Endoscopic full-thickness plication (EFTP) is a minimally invasive alternative that improves the valvular mechanism of the gastroesophageal junction. This meta-analysis compared EFTP to a sham procedure for the treatment of refractory GERD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This meta-analysis followed the Cochrane guidelines and PRISMA standards and was registered with PROSPERO (CRD42023485506). We searched MEDLINE, Embase, SCOPUS, and Cochrane Library through December 2023. Inclusion criteria targeted Randomized controlled trials comparing EFTP with sham procedures for GERD were included. Statistical analyses utilized RevMan with a random-effects model, and the results were considered significant at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2144 screened studies, three RCTs with 272 patients with GERD were included: 136 patients underwent EFTP and 136 underwent sham procedures. Primary outcomes showed a significant reduction in PPI usage (RR 0.51; 95% CI 0.35–0.73; <i>p</i> &lt; 0.01) and more than 50% improvement in GERD-HRQL scores at 3 months (RR 15.81; 95% CI 1.40–178.71; <i>p</i> = 0.03). No significant difference was found in the DeMeester scores (MD: 12.57; 95% CI −35.12 to 9.98; <i>p</i> = 0.27). Secondary outcomes showed no significant difference in time with esophageal pH &lt; 4, but a significant reduction in total reflux episodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EFTP significantly reduced PPI usage, improved GERD-HRQL scores, and decreased total reflux episodes compared with sham procedures, highlighting its potential as a minimally invasive treatment. Further research is needed to compare EFTP with other minimally invasive techniques to determine the most effective treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737533","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":"Gastroduodenal Polyposis Secondary to Extrahepatic Portal Venous Obstruction","authors":"Christopher Wen Wei Ho,&nbsp;Kenneth Tou En Chang,&nbsp;Fang Kuan Chiou","doi":"10.1002/jgh3.70060","DOIUrl":"https://doi.org/10.1002/jgh3.70060","url":null,"abstract":"&lt;p&gt;This is a 16-year-old male who first presented in infancy for poor weight gain and splenomegaly. Ultrasound and computed tomography imaging of the abdomen revealed extrahepatic portal vein obstruction (EHPVO) and portal hypertension, with chronic portal vein thrombosis, cavernous transformation of the portal vein, splenomegaly, and portal venous shunts.&lt;/p&gt;&lt;p&gt;He developed his first variceal bleed at 3 years old, with endoscopic variceal ligation of esophageal varices and injection sclerotherapy of gastric varices done successfully. Over the years, there was no recurrence of variceal bleed, though his spleen size had gradually increased in size with hypersplenic effect of leukopaenia, thrombocytopaenia, and anemia. There was no evidence of liver cirrhosis. At 16 years of age, he presented with hepatic encephalopathy and a drop in hemoglobin (from 10.4 to 7.0 g/DL) with suspected occult gastrointestinal bleeding. There was no overt haematemesis or melaena. Oesophagogastroduodenoscopy showed non-bleeding Grade II esophageal varices for which endoscopic variceal ligation was performed. Multiple sessile polyps measuring approximately up to 5 mm were seen in the stomach antrum as well as in the second part of duodenum (Figure 1a–d). Overlying mucosa of these polyps appeared congested and although there was increased venous bleeding during biopsy, bleeding resolved without further intervention. Histology showed increased ectatic lamina proprial capillaries in the laminal propria with no dysplasia, findings which were in keeping with microscopic changes attributable to portal hypertension (Figure 1e).&lt;/p&gt;&lt;p&gt;Portal hypertensive polyps (PHP) have been described as a rare endoscopic feature of portal hypertension, along with other more common findings of oesphageal varices, gastropathy, gastric antral vascular ectasia, enteropathy, and colopathy [&lt;span&gt;1&lt;/span&gt;]. It has been postulated that polyps develop because of neovascularization secondary to high portal pressure. PHP have been mainly described in the stomach and duodenal involvement is not common, with paucity of literature in children [&lt;span&gt;2&lt;/span&gt;]. Differential diagnoses of PHP include pancreatic or gastric heterotopia, adenomatous polyps, and inflammatory polyps. Histological findings of proliferating capillaries in the lamina propria indicates a vascular etiology, distinguishing them from inflammatory polyps [&lt;span&gt;3&lt;/span&gt;]. The absence of dysplasia rules out an adenomatous nature for these polyps. Other histological findings of PHP described are vascular ectasia/congestion/thrombi, gastric foveolar metaplasia, reactive nuclear atypia, fibrosis, and smooth muscle proliferation.&lt;/p&gt;&lt;p&gt;PHP have been associated with increased risk of bleeding due to underlying vascular congestion. In this case, the patient did not present with overt variceal bleeding, and ectopic bleeding from the PHP was postulated to have contributed to the anemia and triggered hepatic encephalopathy. Lowering portal pressur","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724179","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":"Readmission Rate, Predictors, Outcomes, and Burden of Readmission of Hepatorenal Syndrome in the United States: A Nationwide Analysis","authors":"Abdullah Sohail,&nbsp;Ammad J. Chaudhary,&nbsp;Muhammad Mujtaba Bhinder,&nbsp;Khadija Zahid,&nbsp;Kyle Brown","doi":"10.1002/jgh3.70062","DOIUrl":"10.1002/jgh3.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nationwide US data on readmission rates for patients with cirrhosis admitted with hepatorenal syndrome (HRS) is lacking. We reviewed 30-day readmission rates after HRS-related hospitalizations, the associated predictors of readmissions, and their impact on resource utilization and mortality in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified all adults admitted with HRS between 2016 and 2019 using the Nationwide Readmission database of the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project. The primary outcome was all-cause 30-day readmission rate. Secondary outcomes were inpatient mortality rate, predictors of readmission, and resource utilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 245 850 hospitalizations of patients admitted for HRS in the United States from 2016 to 2019. Of these, 214 890 met the inclusion criteria. Mean age was 59.16 years, and 61.31% were males. Medicare was the most common primary payer (44.82%) followed by Medicaid (25.58%). The readmission rate was 24.6% within 30 days of discharge from index hospitalization. The most common cause of readmission was alcoholic cirrhosis with ascites (14.87%), followed by sepsis (9.32%) and unspecified hepatic failure (9%). The in-hospital mortality rate for index hospitalization was 29.52% and 14.35% among those readmitted within 30 days. The mean length of stay (12.33 days vs. 7.15 days, <i>p</i> &lt; 0.01) and hospitalization costs ($44 903 vs. $22 353, <i>p</i> &lt; 0.01) were higher for index hospitalizations than readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrated that all-cause 30-day readmission and in-hospital mortality rates after the development of HRS were strikingly high. This warrants health policies and interventions at the institutional level, including close post-hospital discharge follow-up, to decrease readmission rates, improve patient outcomes, and reduce cost burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733165","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":"Switching to Tenofovir Therapy Versus Continuation of Entecavir for Patients With Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis","authors":"Muhammad Shahzil,&nbsp;Ammad Javaid Chaudhary,&nbsp;Talha Kashif,&nbsp;Ali Akram Qureshi,&nbsp;Anza Muhammad,&nbsp;Faiza Khan,&nbsp;Muhammad Saad Faisal,&nbsp;Muhammad Ali Khaqan,&nbsp;Hassam Ali,&nbsp;Yara Dababneh,&nbsp;Dilip Moonka","doi":"10.1002/jgh3.70055","DOIUrl":"https://doi.org/10.1002/jgh3.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatitis B virus (HBV) infection causes liver disease, including hepatocellular carcinoma. Controlling viral activity is crucial to reducing complications. Tenofovir may offer benefits over entecavir, but it is unclear if switching from entecavir to tenofovir improves outcomes. This study assesses the clinical impact of switching to tenofovir therapy for chronic HBV infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the PRISMA guidelines, we conducted a literature search within the Cochrane Library, PubMed, MEDLINE, Embase, and Scopus for studies of patients with HBV infection who were switched to tenofovir from entecavir or were maintained on entecavir. Both formulations of tenofovir, that is, tenofovir disoproxil fumarate and tenofovir alafenamide were included and analyzed in subgroup analysis. Meta-analyses were performed with RevMan 5.4 using a random-effects model, with statistical significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of eight studies, comprising 833 patients, were included in the meta-analysis. Tenofovir showed a significantly higher likelihood of achieving complete virological response (RR 5.60; 95% CI 3.51–8.94; <i>p</i> &lt; 0.00001) and a greater reduction in HBV DNA levels (MD −1.03 log IU/mL; 95% CI −1.69 to −0.36; <i>p</i> = 0.002) compared to entecavir. However, there was no significant difference in HBsAg reduction or HBeAg seroconversion between the two groups. ALT reductions were not statistically significant overall, although entecavir showed better outcomes in subgroup analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Switching from entecavir to tenofovir improves virological response and reduces HBV DNA levels, but shows no significant advantage in HBsAg reduction, HBeAg seroconversion, or overall, ALT reduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708025","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":"Influence of patient characteristics on Helicobacter pylori eradication with Vonoprazan: A subgroup analysis of the pHalcon-HP trial","authors":"William D Chey,&nbsp;Francis Mégraud,&nbsp;Loren Laine,&nbsp;Neila Smith,&nbsp;Eckhard Leifke,&nbsp;Barbara Hunt,&nbsp;Colin W Howden","doi":"10.1002/jgh3.70044","DOIUrl":"https://doi.org/10.1002/jgh3.70044","url":null,"abstract":"<p>The efficacy of vonoprazan-based dual and triple therapy vs. lansoprazole-based triple therapy in the treatment of <i>H. pylori</i> infection was largely consistent regardless of age, sex, race, ethnicity, BMI, alcohol intake, smoking status, and study drug compliance.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"8 11","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642123","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}