Canadian Journal of Gastroenterology and Hepatology最新文献

{"title":"Risk Factors Related to the Development of Nonalcoholic Fatty Liver: A Systematic Review.","authors":"Omaira Valencia, Carolina López, Esteban Vanegas-Duarte, Carolina Fillizola, Diana Fernanda Bejarano Ramírez, Nicolás Andrés Cortés Mejía, Alonso Vera Torres","doi":"10.1155/cjgh/9964486","DOIUrl":"10.1155/cjgh/9964486","url":null,"abstract":"<p><p><b>Background:</b> Nonalcoholic fatty liver disease (NAFLD) has a major impact on public health owing to its high morbidity and mortality due to its close relationship with several conditions, including metabolic syndrome, cirrhosis, and cancer. Therefore, this review aimed to systematically compile and summarize the scientific literature on early risk factors for NAFLD development. <b>Methods:</b> A systematic review of population-based cohort studies was conducted. Studies reporting the risk factors associated with nonalcoholic steatohepatitis (NASH) and NAFLD were screened. <b>Results:</b> The search yielded 987 unique records, of which 196 articles were selected after title and abstract screening. A total of 39 articles were read in full text after quality analysis using Downs and Black criteria; 10 of the studies were excluded due to heterogeneity or inconclusive results. Finally, 30 publications were included in this systematic review. The review revealed that clinical conditions such as obesity, weight change, psoriasis, polycystic ovary syndrome, diabetes, thyroid disorders, and elevated serum uric acid levels increase the risk of developing nonalcoholic fatty liver. In addition, lifestyle factors such as sedentary behavior, active or passive smoking, poor sleep quality, and consumption of carbonated beverages are associated with this condition. <b>Conclusions:</b> Evidence was found on the association between different clinical and lifestyle risk factors and NAFLD. This supports the need for preventive, diagnostic, and therapeutic strategies to improve the metabolic, hepatic, and oncological outcomes related to this condition.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9964486"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Phase 2, Multi-Center, Randomized, Double-Blind, Parallel-Group Trial to Evaluate the Efficacy and Safety of CKD-495 in Patients With Acute and Chronic Gastritis.","authors":"Su Hyun Park, Oh Young Lee, Yong Chan Lee, Kyung Sik Park, Jong Jae Park, Moo In Park, Geun Am Song, Dong Ho Lee, Hyunsoo Jung, Sung Kook Kim, Tae Nyeun Kim, Suck-Chei Choi, Sam Ryong Jee, Jong Sun Rew, Soo Teik Lee, Eun Kwang Choi, Gwang Ho Baik, Shin Jung Park","doi":"10.1155/cjgh/2702089","DOIUrl":"https://doi.org/10.1155/cjgh/2702089","url":null,"abstract":"<p><p>CKD-495 is a newly developed drug extracted from Cinnamomum cassia Presl. This phase II study assessed the clinical benefits of CKD-495 in the treatment of acute and chronic gastritis. This study randomly assigned 250 patients with endoscopically-proven gastric mucosal erosion to five groups. The groups received either 75 mg or 150 mg of CKD-495, 100 mg of rebamipide, 60 mg of Artemisiae argyi folium 95% ethanol ext. (20 ⟶ 1) (Stillen; Dong-A ST Co., Ltd., Seoul, Korea), or placebo for 2 weeks, respectively. The primary endpoint was the erosion improvement rate, and the secondary endpoints were erosion cure rates, improvement rates of gastrointestinal symptoms, edema, redness, and hemorrhage. Drug-related adverse events were evaluated. The endoscopic erosion improvement rate was significantly higher in the 75 mg CKD-495 group than in the other groups in both the full analysis set (73% vs. 41%, 45%, 52%, 48% for the 75 mg CKD-495, 150 mg CKD-495, placebo, 60 mg Stillen, and 100 mg rebamipide groups, respectively) and the per-protocol set (PPS) (75% vs. 37%, 45%, 51%, 50%). The cure rate of gastric erosion was significantly higher in the 75 mg CKD-495 group than in the other groups. The improvement rates of hemorrhage erosion were significantly higher in the 150-mg CKD-495 group. No significant differences were observed in the safety profiles. No serious adverse events or drug reactions were observed. These results demonstrate that 75 mg of CKD-495 has excellent efficacy for the treatment of endoscopic and symptomatic improvements for acute and chronic gastritis. <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03437785.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"2702089"},"PeriodicalIF":2.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol Use Disorder Pharmacotherapy in Patients With Alcohol-Related Liver Disease: A Scoping Review.","authors":"Manisha Jogendran, Louis Huynh, Jennifer A Flemming","doi":"10.1155/cjgh/6455092","DOIUrl":"https://doi.org/10.1155/cjgh/6455092","url":null,"abstract":"<p><p><b>Introduction:</b> Alcohol-associated liver disease (ALD) is one of the most common causes of cirrhosis. Pharmacotherapy for alcohol use disorder (AUD) can improve abstinence rates in patients with cirrhosis, however, there is limited data on how these therapies affect liver-related outcomes. <b>Methods:</b> A scoping review was completed using multiple electronic search databases. Articles exploring pharmacotherapy for AUD and outcomes for ALD were included. The primary outcome of this study was liver outcomes after receiving pharmacotherapy for AUD, including decompensated cirrhosis, mortality, progression of ALD, and need for liver transplantation. <b>Results:</b> A total of 2521 studies were screened and 3 were selected. A total of 45,948 patients were included, 43,863 (98%) of patients were male, and the mean age was 58.7. Only 2299 (5%) of patients received AUD pharmacotherapy. Receipt of AUD pharmacotherapy was found to be associated with decreased hepatic decompensation and mortality in 2 out of 3 studies. <b>Conclusion:</b> There are limited studies that explore AUD pharmacotherapy and ALD outcomes. Medications AUD may improve hepatic outcomes; however, further prospective studies need to be completed to explore this association.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"6455092"},"PeriodicalIF":2.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of TyG-Related Indices in Evaluating MASLD and Significant Liver Fibrosis in MASLD.","authors":"Haoxuan Zou, Jiejie Xie, Xiaopu Ma, Yan Xie","doi":"10.1155/cjgh/5871321","DOIUrl":"10.1155/cjgh/5871321","url":null,"abstract":"<p><p><b>Background:</b> Triglyceride glucose (TyG) and its related index (TyG-body mass index, TyG-BMI) are recognized as markers for nonalcoholic fatty liver disease (NAFLD), but their associations with metabolic dysfunction-associated steatotic liver disease (MASLD) and significant liver fibrosis (SLF) risk are less studied. Therefore, this study explores the effectiveness of these indices in assessing MASLD and SLF risk in the U.S. population. <b>Methods:</b> Utilizing data from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional study involving 5520 participants from the general population was performed. This research measured demographic, anthropometric, biochemical, comorbid, and lifestyle characteristics, all of which are considered risk factors for MASLD/SLF. <b>Results:</b> Upon controlling for confounding variables, only the TyG-BMI was found to have a consistent positive association with the risk of MASLD and SLF. Specifically, for each standard deviation increase, the odds ratio (OR) and 95% confidence interval (CI) were 4.44 (3.64-9.26, <i>p</i> for trend < 0.001) for MASLD and 2.48 (2.15-2.87, <i>p</i> for trend < 0.001) for SLF. Significant interactions were identified among age, sex, and the risk of MASLD associated with the TyG-BMI. The TyG-BMI also had a significant threshold effect on the risk of MASLD at a cutoff point of 180.71. Furthermore, the area under the receiver operating characteristic curve (AUC) revealed that the TyG-BMI better predicted the risk of MASLD and SLF (AUC 0.820, 95% CI 0.810-0.831; AUC 0.729, 95% CI 0.703-0.756, respectively). In addition, the integrated discrimination improvement (IDI), decision curve analysis (DCA), and net reclassification index (NRI) also demonstrated the satisfactory predictive ability of the TyG-BMI. <b>Conclusions:</b> Within this large dataset, the TyG-BMI was independently associated with both the MASLD score and the SLF in the MASLD cohort. Its predictive efficacy consistently surpassed that of TyG and other noninvasive models, indicating that TyG-BMI has potential for the early identification of MASLD and SLF risk.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"5871321"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Antiviral Therapy in Chronic Hepatitis B Patients With Normal Alanine Aminotransferase: A Systematic Review and Meta-Analysis.","authors":"Yuting Diao, Yueying Zeng, Zhihao Huang, Chunfang You","doi":"10.1155/cjgh/7689981","DOIUrl":"https://doi.org/10.1155/cjgh/7689981","url":null,"abstract":"<p><p><b>Background and objectives:</b> The efficacy of antiviral therapy in chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) is controversial. This study aimed to systematically review and analyze antiviral efficacy in ALT-normal CHB patients. <b>Methods:</b> PubMed, Embase, Web of Science, and the Cochrane Library databases from inception to 17 May 2024 were searched for retrieving relevant studies with antiviral efficacy of ALT-normal CHB patients. <b>Results:</b> Of 4992 records screened, 10 studies met the criteria for inclusion and had a low risk of bias. The pooled proportions of undetectable HBV DNA, HBeAg loss, HBeAg seroconversion, HBsAg loss, and HBsAg seroconversion in ALT-normal CHB patients with antiviral therapy were 87%, 35%, 19%, 16%, and 10%, respectively. Subgroup analysis suggested that the virological and serological responses were better in patients receiving IFN-based therapy or with a longer follow-up time. Compared with no treatment, antiviral therapy was associated with significant higher rates of undetectable HBV DNA (RR: 65.62, 95% CI: 16.65-258.57, and <i>p</i> < 0.01), HBeAg loss (RR: 14.97, 95% CI: 3.31-67.65, and <i>p</i> < 0.01), HBsAg loss (RR: 14.22, 95% CI: 4.10-49.29, and <i>p</i> < 0.01), and HBsAg seroconversion (RR: 24.65, 95% CI: 3.06-198.60, and <i>p</i> < 0.01). The normal ALT group and elevated ALT group had comparable antiviral efficacy including proportions of undetectable HBV DNA, HBeAg loss, and HBeAg seroconversion (<i>p</i> > 0.05). <b>Conclusions:</b> CHB patients with normal ALT could benefit from antiviral therapy, and the virological and serological responses were comparable to that of ALT-elevated ones.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"7689981"},"PeriodicalIF":2.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthropometric Indices and Metabolic Dysfunction-Associated Fatty Liver Disease in Males and Females Living With Severe Obesity.","authors":"Fannie Lajeunesse-Trempe, Selena Dugas, Ina Maltais-Payette, Ève-Julie Tremblay, Marie-Eve Piché, Georgios K Dimitriadis, Annie Lafortune, Simon Marceau, Laurent Biertho, André Tchernof","doi":"10.1155/cjgh/5545227","DOIUrl":"10.1155/cjgh/5545227","url":null,"abstract":"<p><p><b>Introduction:</b> Metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent among people living with severe obesity (body mass index [BMI] ≥ 35 kg/m²). However, it remains unknown how sex and adipose tissue distribution are related to MAFLD onset and progression into metabolic dysfunction-associated steatohepatitis (MASH) or advanced stages of fibrosis. <b>Methodology:</b> We retrospectively studied patients with severe obesity who were eligible for bariatric surgery. Demographic characteristics, biomarkers, and cardiometabolic comorbidities were reported. Anthropometric indices such as BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck circumference (NC), lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), and body roundness index (BRI) were measured or calculated. MAFLD, MASH, and stages of fibrosis (F1-F4) were established from perioperative liver biopsies. Standardized univariate and multivariate logistic regression analyses were used to examine the association between demographic variables, anthropometric indices, cardiometabolic conditions, and the risk of MASH or severe fibrosis (F2-F4). <b>Results:</b> A total of 2091 participants with severe obesity were included in the analyses; BMI 47.9 ± 7.3 kg/m², age 46.2 ± 11.2 years, and 68.4% females. Overall, MAFLD prevalence was 79.5%, with 44.5% having MASH and 24.4% having severe fibrosis (Stage 2 or higher). No anthropometric indices of adiposity were associated with MASH or fibrosis severity. In this population, female sex was a risk factor for severe fibrosis (OR: 1.27, 95% CI 1.01-1.59, <i>p</i> < 0.05). <b>Conclusions:</b> MAFLD and MASH are highly prevalent in individuals living with severe obesity, but no anthropometric indices or laboratory tests are good predictors of MAFLD or MASH in this population. When MAFLD is diagnosed, our results suggest that females with severe obesity might be at higher risk of advanced stages of fibrosis.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"5545227"},"PeriodicalIF":2.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Drug Monitoring for Dose Optimization of Infliximab in Patients With Inflammatory Bowel Disease: An Analysis of Canadian Real-World Data.","authors":"David C Sealey, Kai Fai Ho, Z Christina Zhou, Michael Clark, Brian G Feagan, Remo Panaccione, A Hillary Steinhart, Elena Bolshtyansky, Martin Williamson, Waqqas Afif","doi":"10.1155/cjgh/5713315","DOIUrl":"10.1155/cjgh/5713315","url":null,"abstract":"<p><p><b>Background:</b> Although it is generally believed that infliximab dose optimization in patients with inflammatory bowel disease with low serum infliximab concentration at trough results in increased treatment persistence, empirical data to support this notion are lacking. This study evaluated the association of infliximab therapeutic drug monitoring (TDM) and TDM-associated dose optimization with persistence in real-world practice. <b>Methods:</b> Data from adults with Crohn's disease (CD) or ulcerative colitis (UC) who participated in a national patient support program (PSP) in Canada were analyzed. Participants who had a first TDM evaluation (with a recorded infliximab trough concentration) in the maintenance phase of treatment were assessed (excluding those who underwent prior dose optimization). Persistence was evaluated using time-dependent Cox proportional hazards models. <b>Results:</b> In the overall population of patients with CD or UC, TDM was not associated with longer persistence (<i>n</i> = 13,203). In patients with no prior dose optimization (<i>n</i> = 2729) who had a serum infliximab concentration of < 3 μg/mL, dose optimization within 9 weeks of TDM was associated with significantly longer persistence (HR: 0.36; 95% CI: 0.26, 0.50 for CD [<i>n</i> = 711] and HR: 0.30, 95% CI: 0.21, 0.43 for UC [<i>n</i> = 501]). Sensitivity analyses yielded similar results when using a threshold concentration of < 5 μg/mL. In an analysis excluding patients who received no further treatment after TDM, the association between dose optimization and longer persistence was not confirmed in patients with CD, and mostly confirmed in patients with UC at a threshold concentration of < 3 μg/mL. <b>Conclusion:</b> TDM-associated dose optimization in patients with UC with low serum infliximab concentrations was associated with longer persistence. This association was not confirmed in patients with CD. This study demonstrated that real-world data from a PSP-generated cohort can be evaluated to inform clinical practice and that this approach may be complementary to other types of cohort studies.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"5713315"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Negative Video Capsule Endoscopy Had a High Negative Predictive Value for Small Bowel Lesions, but Diagnostic Capability May Be Lower in Young Patients with Overt Bleeding\".","authors":"Sipawath Khamplod, Julajak Limsrivilai, Uayporn Kaosombatwattana, Nonthalee Pausawasdi, Phunchai Charatcharoenwitthaya, Supot Pongprasobchai, Somchai Leelakusolvong","doi":"10.1155/cjgh/9836801","DOIUrl":"10.1155/cjgh/9836801","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/2021/8825123.].</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9836801"},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kupffer-Cell-Targeted Carboxylesterase 1f Knockdown Deteriorates Lipopolysaccharide/D-Galactosamine-Induced Acute Liver Failure Through Regulating Cellular Polarization in Mice.","authors":"Sai Zhao, Xue Yang, Yu He, Qian Yu, Liang-Ming Liu","doi":"10.1155/cjgh/6410484","DOIUrl":"10.1155/cjgh/6410484","url":null,"abstract":"<p><p><b>Background:</b> Aims: Carboxylesterase (Ces)1f is implicated in protection against hepatic inflammation, but it is unclear whether the enzyme has an influence in polarization of Kupffer cells (KCs), the innate immune cells mediating hepatic inflammatory injury including acute liver failure (ALF). In the present study, we aim to explore KC polarization induced by Ces1f in mice with lipopolysaccharide/D-galactosamine (LPS/D-GalN)-induced ALF. <b>Methods:</b> We adopted a novel delivery system, β-1,3-D-glucan-encapsulated Endoporter-siRNA particles, to specifically target KC Ces1f knockdown via tail vein injection in mice. <b>Results:</b> Ces1f knockdown increased LPS/D-GalN-induced lethality as well as serum levels of alanine and aspartate transaminases, deteriorated hepatic inflammatory injury, and imbalanced hepatic oxidative stress molecules including myeloperoxidase, malondialdehyde, and superoxide dismutase in ALF. Ces1f knockdown also increased the levels of proinflammatory cytokines (tumor necrosis factor-<i>α</i> and interleukin-6) and decreased the levels of anti-inflammatory cytokine (interleukin-10) in LPS/D-Gal-induced ALF. Ces1f knockdown promoted KC M1 phenotype and marker expression (including CD86 and interleukin-1β), but inhibited M2 phenotype and marker expression (including CD163, CD206, and Arginase 1). <b>Conclusions:</b> Our results suggest that Ces1f plays a hepatoprotective role through regulating KC polarization, which might contribute to anti-inflammatory and antioxidative effects in LPS/D-Gal-induced ALF mice.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2024 ","pages":"6410484"},"PeriodicalIF":2.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Virtual Ruler-Based Diameter Measurement in Endoscopic Therapy for Cirrhotic Esophageal Varices: A Retrospective Multicenter Study.","authors":"Zhongliang Fang, Yuchuan Bai, Yudi Mao, Jing Jin, Qianqian Zhang, Yangchen Tang, Xiping Ding, Derun Kong","doi":"10.1155/cjgh/8823825","DOIUrl":"10.1155/cjgh/8823825","url":null,"abstract":"<p><p><b>Background:</b> Esophageal variceal (EV) diameter is a critical, independent risk factor for hemorrhage, and plays a key role in guiding choices of endoscopic treatment techniques. We developed a novel tool, the virtual ruler (VR), which offers increased precision and expediency in EV diameter (EVD) measurements. This study investigates the clinical value of VR for assessing EVD during the endoscopic treatment of cirrhotic EVs. <b>Methods:</b> We performed a retrospective multicenter review of 345 cirrhotic patients with EVs who received endoscopic treatment. EVD was measured using VR, and several outcomes, including rebleeding rates, vascular eradication rates, mortality, and complication incidences, were compared in patients stratified by EVD as measured by both VR and endoscopists. <b>Results:</b> There was moderate agreement between VR and endoscopist measurements of EVD (Kappa = 0.591, <i>p</i> < 0.001). In patients with EVD > 1 cm, the VR group had a lower rebleeding rate after endoscopic treatment compared to the endoscopist group (3.8% vs. 11.3%; <i>p</i>=0.048). No significant between-group differences in outcomes were noted in patients with EVD ≤ 1 cm. Additionally, comparisons of endoscopic variceal ligation and endoscopic injection sclerotherapy within the VR-based diameter groups showed no substantial differences in treatment efficacy or adverse events (<i>p</i> > 0.05). <b>Conclusion:</b> Using VR to accurately measure EVD may help decrease endoscopist misjudgment of larger EVD values and may reduce postoperative rebleeding rates after endoscopic treatment. VR holds potential clinical significance in guiding endoscopic EV treatment. <b>Trial Registration:</b> Clinical Trial Registry identifier: ChiCTR2200064028.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2024 ","pages":"8823825"},"PeriodicalIF":2.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}