Canadian Journal of Gastroenterology and Hepatology最新文献

{"title":"Rifaximin Plus Probiotics Reshape Gut Microbiota, Serum Propionate, and Mucosal Immunity in Cirrhosis-Related Hepatic Encephalopathy Microbiota-Immune Remodeling in HE.","authors":"Yiping Wang, Hui Zhu, Shujun Wang, Danni Hu, Mengdan Xu, Luna Lee, Dylan Lee","doi":"10.1155/cjgh/2389961","DOIUrl":"10.1155/cjgh/2389961","url":null,"abstract":"<p><strong>Background: </strong>Hepatic encephalopathy (HE) remains a major cause of hospitalization and readmission in cirrhosis and is closely linked to hyperammonemia, microbial dysbiosis, impaired short-chain fatty acid (SCFA) output, barrier dysfunction, and altered mucosal immunity. We evaluated whether adding a multistrain probiotic to rifaximin was associated with greater neurometabolic improvement and coordinated gut-liver-brain axis changes.</p><p><strong>Methods: </strong>In this prospective, 6-month, randomized, open-label, assessor-blinded, three-arm controlled study, 61 adults with cirrhosis-related HE received standard care alone (Con, n = 20), standard care plus rifaximin 550 mg twice daily (Rif, n = 20), or rifaximin plus a multistrain probiotic (1 × 10^9 CFU three times daily; Rif + Pro, n = 21). The main prespecified biochemical readout was serum ammonia at Month 6. A composite HE index incorporating mental status, flapping tremor, number connection test, and ammonia grade was analyzed as a prespecified exploratory neurometabolic score. A predefined mechanistic subset underwent 16S rRNA microbiome profiling, serum SCFA measurement, and fecal secretory IgA (SIgA) testing.</p><p><strong>Results: </strong>Baseline characteristics did not differ across arms. Post-treatment serum ammonia decreased in a graded pattern (Con 177 ± 43.2, Rif 143 ± 37.5, Rif + Pro 117 ± 34.3 μmol/L), with parallel improvement in the exploratory HE index (10.0 ± 4.9, 5.3 ± 4.7, and 3.7 ± 4.1, respectively). In the mechanistic subset, the microbial community structure differed by treatment (PERMANOVA p = 0.006). Rif + Pro was associated with higher serum propionate, increased Lactobacillus salivarius-associated signal, reduced Bacteroides ovatus-associated signal, and marked fecal SIgA elevation compared with standard care or rifaximin alone. The SIgA-propionate relationship was interpreted as exploratory.</p><p><strong>Conclusions: </strong>Rifaximin plus multistrain probiotics was associated with greater improvement in serum ammonia and exploratory HE severity readouts than rifaximin alone, accompanied by coordinated microbial, metabolic, and mucosal immune changes. These findings support confirmation in adequately powered event-driven trials with strain-resolved profiling and targeted metabolomics.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e2389961"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438698","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":"Beyond the INR: Thromboelastography Carries Prognostic Information in Critically Ill Patients With Cirrhosis.","authors":"Franklyn K Wallace, Puru Rattan, Ryan J Lennon, Alice Gallo De Moraes, Douglas A Simonetto","doi":"10.1155/cjgh/5532035","DOIUrl":"10.1155/cjgh/5532035","url":null,"abstract":"<p><strong>Background: </strong>In patients with cirrhosis, prolonged international normalized ratio (INR) is primarily driven by liver synthetic dysfunction. Thromboelastography more accurately reflects coagulability and can also predict short-term mortality. Nevertheless, INR is used to define coagulation failure in the European Foundation for the Study of Chronic Liver Failure criteria for acute-on-chronic liver failure (ACLF).</p><p><strong>Aim: </strong>To evaluate the association between TEG parameters and mortality in critically ill patients with cirrhosis and to justify future investigation into TEG as a prognostic tool in ACLF.</p><p><strong>Methods: </strong>We performed a retrospective study of 52 patients with cirrhosis admitted to the intensive care unit (ICU) who had TEG performed during their ICU admission prior to the administration of any blood products. We assessed the association between TEG parameters and 28-day mortality.</p><p><strong>Results: </strong>Patients who did not survive beyond 28 days generally had more hypocoagulable TEG parameters (R time: 10.0 vs. 7.6, p = 0.03; K time: 3.4 vs. 2.2, p = 0.003; alpha angle: 53.1 vs. 63.5, p = 0.002; MA: 49.2 vs. 60.2, p = 0.001). Although global assessment of TEG demonstrated a state of rebalanced hemostasis among critically ill patients with cirrhosis, patients meeting diagnostic criteria for ACLF tended to have more hypocoagulable TEG parameters as compared to those who did not (coagulation index: 0.2 vs. 2.0, p = 0.004). As proof of concept, MA was incorporated into the definition of ACLF to replace INR as a marker of coagulation failure (TEG-ACLF). The area under the curve (AUC) for TEG-ACLF was 0.83 (0.72-0.95) compared to 0.8 (0.68-0.92) for the current ACLF-CLIF grading, with 9.6% (5/52) of patients being reclassified into a different ACLF grade.</p><p><strong>Conclusion: </strong>Hypocoagulable TEG parameters are associated with increased 28-day mortality in critically ill patients with cirrhosis, and incorporation of TEG parameters into a modified definition for ACLF may result in improved prediction of short-term mortality.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e5532035"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537082","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":"Development and Validation of the Steatotic Liver Disease Lab Data Index: A Refined Diagnostic Tool.","authors":"Weiting Liaw, Pei-Chien Tsai, Ming-Lung Yu, I-Jung Feng","doi":"10.1155/cjgh/7366206","DOIUrl":"10.1155/cjgh/7366206","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;Steatotic liver disease (SLD) is highly prevalent, yet large-scale identification remains challenging because imaging is not always available and existing noninvasive indices perform heterogeneously across subgroups. We developed and validated sex- and age-stratified laboratory-based indices for simplified SLD identification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed 2085 adults from NHANES III (1988-1994). An exposure-wide association study (EWAS) of 119 clinical features informed sex- and age-stratified logistic models to derive two SLD lab data indices (SLDLD1-2) and simplified categorical versions (SSLDLD1-2). Discrimination (AUROC) was compared with FLI, HSI, NAFLD-LFS, and US-FLI using paired DeLong tests. Bootstrap internal validation, comparison with a pooled nonstratified model, and decision curve analysis were additionally performed. External validation was performed for SSLDLD1 in NHANES 2017-2018 and the Taiwan MJ Health database. SLDLD2/SSLDLD2 were not externally validated because C-peptide was unavailable in both datasets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Central adiposity and insulin-resistance markers were key predictors, whereas β-carotene showed an inverse association and contributed to discrimination, particularly in men. Across strata, SLDLD1 achieved AUROCs of 0.71-0.79 in derivation. The stratified framework outperformed a pooled nonstratified model in the overall cohort, in men, and in women aged &lt; 55 years. SLDLD1 also outperformed FLI and HSI across strata and showed superior or comparable performance versus NAFLD-LFS and US-FLI, with stratum-dependent differences. External validation of SSLDLD1 yielded AUROCs of 0.71-0.80 across datasets. Feature-reduction analysis and an MJ-variables-only implementation of SSLDLD1 showed only small absolute AUROC changes overall, supporting simplified implementation when nonroutine biomarkers such as β-carotene and insulin are unavailable, although fixed NHANES III-derived thresholds were not fully transferable to the MJ cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The stratified SLDLD framework provides a practical toolbox for SLD identification, supporting high-throughput research and implementation in settings where advanced imaging is not readily available. SSLDLD1 showed acceptable external discrimination across U.S. and Taiwanese datasets and may be more feasible for settings without nonroutine biomarkers, although local recalibration and validation of decision thresholds are needed before implementation across populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abbreviations: &lt;/strong&gt;AASLD, American Association for the Study of Liver Diseases; AIC, Akaike information criterion; ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; AUROC, area under the receiver-operating. characteristic curve; BMI, body mass index; CAP, controlled attenuation parameter; CI, confidence interval; CMRF, cardiometabolic risk factor; DM, diabetes mellitus; EWAS, ","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e7366206"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354176","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":"Effects of Internet-Based Lifestyle Interventions on Nonalcoholic Fatty Liver Disease: A Meta-Analysis of Randomized Controlled Trials.","authors":"Chengjie Wang, Yilong Song, Jingjing Wu, Hua Mei","doi":"10.1155/cjgh/5125598","DOIUrl":"10.1155/cjgh/5125598","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the efficacy of internet-based interventions in improving clinical outcomes among patients with nonalcoholic fatty liver disease (NAFLD) and to synthesize evidence for future research directions.</p><p><strong>Methods: </strong>A comprehensive search of nine electronic databases (CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Cochrane Library, Embase, and CINAHL) was conducted from inception to September 23, 2024, to identify randomized controlled trials (RCTs) assessing internet-based lifestyle interventions in NAFLD patients. Two independent researchers screened studies, extracted data, and evaluated methodological quality. Meta-analyses were performed using RevMan 5.3.5 software.</p><p><strong>Results: </strong>Ten RCTs involving 714 participants were included. Compared to the control group, the intervention groups showed significant reductions in BMI, ALT and AST. Weight loss trended toward reduction but was not statistically significant, though subgroup analysis showed significant weight loss in interventions lasting > 3 months.</p><p><strong>Conclusion: </strong>Internet-based interventions significantly improve BMI and liver enzymes in NAFLD patients, with prolonged interventions (> 3 months) enhancing weight loss. Digital platforms show promise for enhancing self-management, though standardized long-term trials are needed to optimize efficacy.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e5125598"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786278","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":"Prophylactic Antibiotic Use and Clinical Outcomes in Patients With Child-Pugh A Cirrhosis and Acute Variceal Bleeding: A Retrospective Cohort Study.","authors":"Jiajia He, Ju Huang, Guofeng Liu, Yuping He, Xiaoze Wang, Jinlin Yang, Li Yang, Xiao Li, Xuefeng Luo","doi":"10.1155/cjgh/2030627","DOIUrl":"10.1155/cjgh/2030627","url":null,"abstract":"<p><strong>Background & aims: </strong>Prophylactic use of antibiotics was found to decrease mortality in patients with cirrhosis and acute variceal bleeding (AVB). Patients with Child A cirrhosis have a low risk of treatment failure and mortality. The present study was designed to investigate the association between antibiotics and Child-Pugh A patients with AVB.</p><p><strong>Methods: </strong>This retrospective analysis was conducted on Child-Pugh class A cirrhotic patients presenting with AVB at West China Hospital between January 2016 and November 2022. The outcome indicators evaluated in this study include the rate of treatment failure within five days, mortality within 6 weeks, incidence of nosocomial infections, and 1-year cumulative mortality.</p><p><strong>Results: </strong>This study ultimately enrolled 237 patients. The day of patients' admission was defined as Day 0. A total of 117 patients received prophylactic use of antibiotics on Days 0-1 (Group A), and 120 patients did not receive antibiotics on Days 0-1 (Group B). Baseline characteristics were well-balanced between the two groups. The 5-day treatment failure was 8.5% in Group A and 6.7% in Group B (p = 0.63). The 6-week mortality was 1.71% in Group A and 0% in Group B (p = 0.24). The incidence of nosocomial infection (5.98% vs. 6.67%, p = 1.00) and 1-year cumulative mortality (4.81% vs. 1.89%, p = 0.40) was comparable between the two groups.</p><p><strong>Conclusions: </strong>The antibiotics' prophylactic use was not associated with 5-day treatment failure or 6-week mortality. Prophylactic use of antibiotics may not be routinely necessary in patients with Child A cirrhosis and AVB.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e2030627"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677941","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":"Predictors of Mortality After Liver Transplantation for Acute Liver Failure: A Multicenter Cohort Study.","authors":"Micheli Fortunato Domingos, Júlio Cezar Uili Coelho, Eduardo José Brommelstroet Ramos, Jorge Eduardo Fouto Matias, Fabio Silveira, João Eduardo Leal Nicoluzzi, Nertan Luiz Tefilli, Julio Cesar Wiederkehr, Abdo Imad El Tawil, Gabriel Kindermann de Farias","doi":"10.1155/cjgh/5051145","DOIUrl":"10.1155/cjgh/5051145","url":null,"abstract":"<p><strong>Introduction: </strong>Acute liver failure (ALF) is a rare and life-threatening condition characterized by rapid deterioration of liver function and often requires urgent liver transplantation (LT). This study aimed to evaluate donor and recipient factors associated with 30-day mortality after LT for ALF.</p><p><strong>Methods: </strong>Medical records of patients who underwent LT for ALF at seven Brazilian transplant centers were reviewed. Patient data were obtained from electronic medical records. The primary outcome was 30-day mortality after LT.</p><p><strong>Results: </strong>Ninety patients who underwent LT for ALF were included. Thirty-day mortality occurred in 46 of 90 patients (51%). In multivariable analysis, higher pretransplant serum creatinine levels (OR 3.49, 95% CI 1.69-8.72; p = 0.003) and the need for mechanical ventilation prior to transplantation (OR 5.46, 95% CI 1.21-28.9; p = 0.033) were independently associated with early mortality. Donor age ≥ 50 years and pretransplant vasoactive drug use were associated with mortality in univariate analysis.</p><p><strong>Conclusion: </strong>Higher pretransplant serum creatinine levels and the need for mechanical ventilation were independently associated with 30-day mortality, whereas donor age ≥ 50 years and pretransplant vasoactive drug use were associated with mortality only in the univariate analysis. These findings support improved pretransplant risk stratification and perioperative management in patients undergoing LT for ALF.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e5051145"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867377","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":"Evaluating the Prognostic Accuracy of New Scores for In-Hospital Outcomes in Cirrhotic Patients With Esophageal Variceal Bleeding.","authors":"Khoa Phuoc Nguyen, Xung Van Nguyen, Nhan Duc Le, Trung Hieu Doan","doi":"10.1155/cjgh/1577589","DOIUrl":"10.1155/cjgh/1577589","url":null,"abstract":"<p><strong>Background: </strong>Esophageal variceal bleeding (EVB) is a serious complication of cirrhosis and a major cause of upper gastrointestinal hemorrhage, carrying substantial risks of mortality and treatment failure. Prognostic scores are essential for guiding management. This study evaluated and compared the predictive accuracy of the ABC and MAP(ASH) scores with established models in cirrhotic patients with EVB.</p><p><strong>Methods: </strong>We retrospectively analyzed 278 cirrhotic patients admitted for EVB at Da Nang Hospital, Vietnam, between January 2022 and January 2025 who underwent endoscopic variceal ligation. Data were collected for ABC, MAP(ASH), AIMS65, and Glasgow-Blatchford scores. Primary outcomes were in-hospital mortality and 5-day treatment failure. Predictive performance was assessed using AUROCs and statistical comparisons.</p><p><strong>Results: </strong>The ABC score achieved the highest AUROC for predicting in-hospital mortality (0.88), significantly surpassing the MAP(ASH), GBS, and AIMS65 scores (p < 0.001 for all pairwise comparisons). A similar trend was observed for predicting 5-day treatment failure, where the ABC score again demonstrated the highest AUROC (0.79), outperforming both the GBS and AIMS65 scores; however, it showed comparable performance to MAP(ASH) (p = 0.19). In addition, the ABC score's risk stratification (low, medium, and high) accurately differentiated patients with varying mortality and treatment failure rates.</p><p><strong>Conclusion: </strong>The ABC score is a highly effective and reliable tool for predicting in-hospital mortality and early treatment failure in cirrhotic patients with EVB. While the MAP(ASH) score remains valuable for predicting early treatment failure, the ABC score offers superior overall prognostic accuracy. These findings suggest that the ABC score can guide clinical decisions, particularly in resource-limited settings.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e1577589"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677920","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":"Low-Volume Plasma Exchange Combined With a Double Plasma Molecular Adsorption System is Superior to Standard-Volume Plasma Exchange in improving the MELD Score and Reducing Plasma Consumption in Adult Patients With Acute Liver Failure: A Multicenter Retrospective Cohort Study From Heilongjiang Province.","authors":"Yang Liu, Jia-Le Deng, Shu-Xiao Qiu, Di Wu, Hui-Ying Liu, Yu-Jia Tang, Yi-Jin Tang, Zi-Yue Zhang, Qing-Min Meng, Yang Gao, Yan Gao, Kai Kang","doi":"10.1155/cjgh/6558811","DOIUrl":"10.1155/cjgh/6558811","url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to investigate the disparities in improving the model for end-stage liver disease (MELD) score and plasma volume consumption between standard-volume plasma exchange (SVPE) and low-volume plasma exchange (LVPE) combined with the double plasma molecular adsorption system (DPMAS) in adult patients with acute liver failure (ALF).</p><p><strong>Methods: </strong>This multicenter cohort study retrospectively enrolled adult patients with ALF who were admitted to the designated hospitals and received conventional drug treatment along with one or more sessions of SVPE or LVPE combined with DPMAS during hospitalization. According to the different therapeutic plasma exchange (TPE) methods received during hospitalization, the enrolled patients were subsequently classified into the SVPE group and the LVPE combined with DPMAS group. Thereafter, the aforementioned demographic characteristics, laboratory parameters, their change rates, and plasma consumption were compared between different groups or before and after TPE.</p><p><strong>Results: </strong>In this multicenter retrospective cohort study, 97 adult patients with ALF were recruited, with a male-to-female ratio of 1.06: 1. Subsequently, they were classified into the SVPE group (n = 48) and the LVPE combined with DPMAS group (n = 49). During hospitalization, they received a total of 97 sessions of SVPE and 91 sessions of LVPE combined with DPMAS. There were significant differences in multiple laboratory parameters before the first SVPE or LVPE combined with DPMAS between different groups, yet the MELD score was not involved. The change rates of multiple laboratory parameters, including the MELD score, and plasma consumption displayed significant differences between the SVPE group and the LVPE combined with DPMAS group.</p><p><strong>Conclusion: </strong>In terms of improving the MELD score of patients with ALF and reducing the plasma volume, the combined use of LVPE and DPMAS is more effective than SVPE.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e6558811"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438545","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":"Recompensation of Liver Cirrhosis: Definition, Mechanism, Etiological Differences, Prognosis, and Challenges.","authors":"Dan Zhou, Kunyi Ba, Tingting Jia, Yi Shen, Li Yang","doi":"10.1155/cjgh/8512168","DOIUrl":"10.1155/cjgh/8512168","url":null,"abstract":"<p><p>The progression from compensated to decompensated cirrhosis has historically been considered irreversible. However, accumulating clinical evidence has given rise to the concept of \"recompensation,\" which posits that a subset of patients with decompensated cirrhosis may regain a compensated state following successful etiological control, leading to a markedly improved prognosis. This review synthesizes current evidence on cirrhosis recompensation, examining its definition, mechanisms, and etiological specificities, while also addressing the prognosis and persistent challenges in this patient population. Further research is needed to refine the definition of recompensation and elucidate the underlying mechanisms and determinants.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e8512168"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436833","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":"Symptom Network Analysis in Patients With Primary Sclerosing Cholangitis.","authors":"Melinda Wang, Amy M Shui, Joanne Hatchett, Stephen J Rossi, Ruth-Anne Pai, Rachel Gomel, Mary Pressley Vyas, Sarah Curup Callif, Ricky Safer, Jessica Rubin, Christopher Bowlus, Donna M Evon, Jennifer C Lai, Michael Li","doi":"10.1155/cjgh/5291248","DOIUrl":"10.1155/cjgh/5291248","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with primary sclerosing cholangitis (PSC) experience numerous symptoms that impact quality of life. We sought to identify PSC-specific symptom clusters and relationships between symptoms to better understand the lived experience of PSC patients.</p><p><strong>Methods: </strong>Presence and severity of 16 symptoms were identified from the international \"Our Voices\" survey collected by PSC Partners Seeking A Cure in 2020. LASSO-regularized partial correlation network analysis was performed using Spearman correlations. The primary analysis utilized symptoms reported within the past 6 months of survey completion, with subgroup analyses conducted on patients with and without inflammatory bowel disease (IBD). Expected influence was computed to quantify the importance of each measure within networks. The Spinglass algorithm was employed to identify communities within networks.</p><p><strong>Results: </strong>Among 970 total participants, 54% were women, and 70% had IBD. Four dominant communities were identified across networks, including global symptoms, psychological symptoms, gastrointestinal symptoms, and cholestatic-related symptoms. Of the 16 symptoms included in network analyses, fatigue and weakness had the most positive influence across multiple networks and across different communities within each network.</p><p><strong>Conclusions: </strong>The complex relationship between co-occurring symptoms in PSC organizes into four dominant symptom clusters. FTG and WEA emerged as strongly influential symptoms that consistently were associated with other symptoms. Our analyses emphasize the complex, co-occurring nature of PSC symptoms, identify highly influential symptoms, and highlight the need to develop patient-reported outcome symptom measures to assess changes in these key symptoms in clinical trials and clinical practice.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e5291248"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185507","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}