Canadian Journal of Gastroenterology and Hepatology最新文献

{"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":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Terrain of Post-Polypectomy Surveillance: Charting the Complex Landscape of Guidelines and Recurrence Risks.","authors":"Xiaojin Tao, Jun Yao","doi":"10.1155/cjgh/2782582","DOIUrl":"https://doi.org/10.1155/cjgh/2782582","url":null,"abstract":"<p><p>Colorectal cancer (CRC) remains a leading cause of global cancer-related morbidity and mortality. The majority of CRC cases arise through two well-established pathways: the conventional adenoma-carcinoma sequence and the serrated neoplasia pathway. Colonoscopic polypectomy significantly reduces the incidence of CRC, yet postoperative recurrence rates remain substantial, underscoring the critical role of post-polypectomy colonoscopic surveillance (PPCS). Recent updates to PPCS guidelines by major gastroenterological societies-including the US Multisociety Task Force (USMSTF), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE), and the Asia-Pacific Task Force-reflect evolving strategies for risk stratification and surveillance intervals. While all guidelines prioritize colonoscopy resources for high-risk populations and reduce burden for low-risk individuals, significant variations persist in definitions of high-risk adenomas (HRA), recommendations for surveillance intervals, and management of specific histological subtypes such as villous architecture. This review comprehensively compares these updated guidelines, highlighting consensus and discordance in clinical recommendations. Furthermore, it synthesizes evidence on multifactorial recurrence risks, encompassing baseline adenoma characteristics, patient-specific factors, and the quality of endoscopic procedures. Regarding the association with the same risk factor, traditional adenomas and serrated polyps may demonstrate heterogeneity. Understanding these elements is essential for optimizing personalized surveillance strategies and reducing recurrent adenoma burden. Finally, we hope that this review will provide decision-making support for countries lacking standalone guidelines and help clinicians navigate complex and contradictory guideline recommendations.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e2782582"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Smoking Cessation Attempts on Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Large Propensity Score-Matched Cohort Study.","authors":"Mohammad Alabbas, Osama Hamid, Barbara Balog, Umesh Bhagat, Omar Saab, Rama Nanah, Omar T Sims, Jamak Modaresi Esfeh","doi":"10.1155/cjgh/5902236","DOIUrl":"10.1155/cjgh/5902236","url":null,"abstract":"<p><strong>Background and aims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent, and smoking is associated with greater disease severity. We investigated whether documented smoking cessation attempts among adults with MASLD were associated with liver-related outcomes, cardiovascular outcomes, and all-cause mortality.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the TriNetX Research Network. Adults (≥ 18 years) with MASLD and documented smoking history were included. A smoking cessation attempt was defined by cessation counseling and/or cessation pharmacotherapy; comparators had no documented cessation attempt. Patients with depressive disorders and competing liver etiologies were excluded. Cohorts were matched 1:1 using propensity scores, and outcomes were analyzed using Cox proportional hazards models. Sensitivity analyses were performed at fixed follow-up horizons of 6 months, 1 year, and 2 years.</p><p><strong>Results: </strong>Among 418,784 eligible patients, 85,639 had a documented cessation attempt and 333,145 did not; after matching, 83,315 patients remained in each cohort. In the matched cohort, cessation attempt was associated with lower hazards of cirrhosis progression (1.7% vs. 2.1%; HR 0.87, 95% CI 0.81-0.93), hepatocellular carcinoma (0.2% vs. 0.3%; HR 0.58, 95% CI 0.48-0.70), portal hypertension (0.8% vs. 1.1%; HR 0.77, 95% CI 0.70-0.86), and MASH progression (2.2% vs. 2.9%; HR 0.76, 95% CI 0.71-0.81). The cessation attempt was also associated with higher hazards of MACE (13.6% vs. 11.4%; HR 1.24, 95% CI 1.20-1.28), peripheral artery disease (4.1% vs. 3.2%; HR 1.33, 95% CI 1.26-1.40), and all-cause mortality (8.5% vs. 7.3%; HR 1.23, 95% CI 1.18-1.27). Fixed-horizon analyses showed similar patterns over time.</p><p><strong>Conclusions: </strong>In adults with MASLD and smoking history, documented smoking cessation attempts were associated with lower hazards of several liver outcomes but higher cardiovascular event rates and mortality, findings likely influenced by residual confounding and clinical risk clustering in patients receiving cessation interventions.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e5902236"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786307","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":"Prognostic Value and Related Molecular Mechanisms of miR-5003-3p in Hepatocellular Carcinoma.","authors":"Hao Yan, Wei Shan, Qian Xia, Wanting Fang","doi":"10.1155/cjgh/1318790","DOIUrl":"10.1155/cjgh/1318790","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a malignant tumor worldwide with a high mortality rate and recurrence rate. Numerous miRNAs are being applied to the healing and prognosis of HCC. A prior investigation predicted that miR-5003-3p was linked to HCC, but the relevant molecular mechanisms were not clear.</p><p><strong>Aim: </strong>To discover the prognostic value and molecular mechanisms concerned of miR-5003-3p in HCC.</p><p><strong>Methods: </strong>A total of 125 tumor specimens from HCC patients were obtained in this study, along with corresponding adjacent noncancerous tissue samples collected as a control. The levels of miR-500-3p and MAL2 in tumor tissues and cells were detected by RT-qPCR. The prognostic value of miR-500-3p was evaluated using Kaplan-Meier curve and COX regression model. The effects of miR-500-3p on cellular malignant phenotypes were assessed via CCK-8 and Transwell assays. The target sites of miR-500-3p were identified using bioinformatics analysis. The dual-luciferase reporter assay validated the target relationship between them.</p><p><strong>Results: </strong>miR-5003-3p levels were remarkably elevated in HCC tissues, and late TNM stage (I + II) was dramatically higher versus early TNM stage (III + IV). Lymph node metastasis, TNM stage, and differentiated degree were linked notably to miR-5003-3p expression. Upregulated miR-5003-3p was an independent risk factor for HCC. In vitro, downregulated miR-5003-3p could induce apoptosis and restrain proliferation, migration, and invasion, which could be rescued by depressed MAL2.</p><p><strong>Conclusion: </strong>miR-5003-3p may be an independent prognostic factor for HCC. Mechanistically, miR-5003-3p negatively regulates MAL2 to promote cellular processes. These findings highlight the potential of miR-5003-3p as a novel prognostic biomarker and a promising therapeutic target for HCC.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e1318790"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Nausea Through Breathing Interventions: A Trial of Written Instructions for Diaphragmatic Breathing Versus a Biofeedback Device.","authors":"Subhankar Chakraborty","doi":"10.1155/cjgh/2341938","DOIUrl":"10.1155/cjgh/2341938","url":null,"abstract":"<p><strong>Background: </strong>Nausea is a distressing symptom affecting ∼7% of the population. Pharmacologic options are limited and often ineffective for chronic nausea. Nonpharmacologic strategies, such as breathing exercises, have shown promise in reducing stress and GI symptoms, but their role in chronic nausea has not been studied. This study addresses this knowledge gap by comparing written diaphragmatic breathing (DB) instructions with a biofeedback device (CalmiGo) for their effect on nausea severity.</p><p><strong>Methods: </strong>In a prospective study, we investigated the effects of breathing exercises using either written instructions for DB or a biofeedback respiratory practice device (CalmiGo) on self-reported severity of nausea. Participants were randomized to either intervention and asked to practice the exercises three times daily for 3 min each time for 6 Weeks. Nausea was evaluated at baseline and every week for 7 Weeks via online self-reported surveys.</p><p><strong>Results: </strong>A total of 85 adults with nausea (n = 44, 51.7% severe nausea) were randomized to either DB (n = 36) or CalmiGo (n = 49). There was no difference between the two groups at baseline in demographic features, anxiety, depression, or nausea severity. Nausea improved at all-time points in both groups with a medium to large effect size. However, after applying false discovery rate correction, the improvement remained significant for DB only at weeks one to three and borderline significant at weeks four to five and Week 7. There was no difference in response rates between the two groups. Age, body mass index, baseline anxiety, and whether one was diabetic were predictive of improvement in nausea after 4 Weeks.</p><p><strong>Conclusion: </strong>In a pilot study, we observed that brief breathing exercises improve nausea. Breathing exercises may be useful as a nonpharmacologic option in the management of nausea, although larger trials are needed to confirm these findings.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2026 1","pages":"e2341938"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Gastroenteropancreatic Neuroendocrine Neoplasms and Inflammatory Factors: Insights From a Two-Sample Mendelian Randomization Analysis.","authors":"Huimin Guo, Yu Li, Bowei Liu, Songtao Liu","doi":"10.1155/cjgh/2591387","DOIUrl":"10.1155/cjgh/2591387","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammation is implicated in the pathogenesis of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs); however, the causal nature of this association remains unclear. This study sought to evaluate the causal relationships between GEP-NENs and inflammatory factors using a two-sample Mendelian randomization (MR) approach.</p><p><strong>Methods: </strong>We performed a two-sample MR analysis to investigate the causal associations between 91 inflammatory proteins and 731 immune cell traits as exposures and the five subtypes of GEP-NENs as the outcomes. The analytical approach employed various methodologies, such as inverse variance weighting, MR-Egger, weighted mode, weighted median, and simple mode. To evaluate the robustness of the results, sensitivity analyses were conducted, which encompassed MR Egger regression, MR multiple gene residual and outlier detection, leave-one-out analysis, and Cochran's <i>Q</i> test. False discovery rate (FDR) correction was applied, and causal relationships at the gene level were deemed significant at <i>p</i> < 0.05 after FDR adjustment.</p><p><strong>Results: </strong>After FDR correction, the findings revealed robust causal associations between genetically predicted HLA DR++ monocyte %leukocyte (OR = 3.09, 95% CI: 1.76-5.44, <i>p</i> < 0.001, FDR = 0.022), HLA DR on CD14+ CD16- monocyte (OR = 1.72, 95% CI: 1.34-2.22, <i>p</i> < 0.001, FDR = 0.010), and HLA DR on CD14+ monocyte (OR = 1.76, 95% CI: 1.36-2.29, <i>p</i> < 0.001, FDR = 0.010) and genetically predicted stomach NENs. Reverse analysis revealed that GEP-NENs had no major impact on inflammation.</p><p><strong>Conclusion: </strong>These findings reveal the immune mechanisms underlying GEP-NENs and highlight potential therapeutic strategies targeting the immune microenvironment of GEP-NENs.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"2591387"},"PeriodicalIF":2.3,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851219","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":"Impact of Urgent Versus Early Endoscopy on Outcomes in Acute Upper Gastrointestinal Bleeding: A Retrospective Study.","authors":"Katarzyna Stasik, Katarzyna Ferenc, Krystian Partyka, Wojciech Kilisiński, Rafał Filip","doi":"10.1155/cjgh/4328051","DOIUrl":"10.1155/cjgh/4328051","url":null,"abstract":"<p><strong>Background and aims: </strong>Acute upper gastrointestinal (UGI) bleeding from variceal and nonvariceal sources is a leading cause of morbidity and mortality. Although current international guidelines recommend performing endoscopy within 24 h of presentation, the added value of very early (\"urgent,\" < 6 h) versus \"early\" (6-24 h) endoscopy remains unclear. Therefore, this study aimed to analyze the impact of urgent versus early endoscopy on clinical outcomes.</p><p><strong>Methods: </strong>In this retrospective cohort study, we reviewed the medical records of 599 patients admitted to the emergency or gastroenterology department who underwent UGI endoscopy. Patients were stratified by timing, urgent endoscopy within 6 h of specialist consultation and early endoscopy between 6-24 h postconsultation. The protocol was approved by the University of Rzeszów Ethics Committee and conducted in accordance with the Declaration of Helsinki.</p><p><strong>Results: </strong>Compared to the early group, patients undergoing urgent endoscopy were younger (<i>p</i> = 0.013), predominantly male, and had higher baseline heart rates (<i>p</i> = 0.0371). Apart from more frequent hypertension in the early group (<i>p</i> = 0.0007), comorbiditiy profiles were otherwise similar. The urgent endoscopy group had longer hospital stays (6.88 vs. 5.95, <i>p</i> = 0.774), more frequent rebleeding within 7 days (<i>p</i> = 0.0213), and slightly higher 30-day all-cause mortality rates. Factors associated with poor prognosis included increases in Rockall's and GB's scores (42% and 19% higher risk per point, respectively) and the presence of active bleeding (105% higher odds).</p><p><strong>Conclusions: </strong>In unadjusted analyses, urgent endoscopy (< 6 h) was associated with worse outcomes, likely reflecting the selection of more severely ill patients. After propensity-score matching for baseline risk factors, however, the timing of endoscopy (< 6 h vs. 6-24 h) was no longer an independent predictor of outcomes. These findings suggest that clinicians' decisions and outcome differences are driven by overall severity of presentation and comorbid burden, rather than the effect of ultra-early endoscopy itself.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"4328051"},"PeriodicalIF":2.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655687","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 Role of Macrophage Polarization and Ferroptosis in the Progression of Liver Fibrosis.","authors":"Jeri Nobia Purnama, Mohammad Ghozali, Desak Made Malini, Ratu Safitri","doi":"10.1155/cjgh/1200073","DOIUrl":"10.1155/cjgh/1200073","url":null,"abstract":"<p><p>Liver fibrosis is a pathological condition marked by excessive extracellular matrix accumulation, potentially leading to cirrhosis. Macrophages play a vital role in regulating inflammatory responses, facilitating tissue repair, and orchestrating extracellular matrix remodeling through their differentiation into proinflammatory and anti-inflammatory phenotypes. Hepatic stellate cell activation and the progression of fibrosis have been linked to ferroptosis, a controlled cell death process triggered by iron and characterized by lipid peroxidation. This review explores the interaction between ferroptosis and macrophage polarization in iron-overload-induced liver fibrosis. It examines how ferroptosis intensifies inflammatory and fibrotic processes through macrophage activity and identifies key macrophage marker proteins involved. Understanding this interplay offers novel therapeutic insights targeting macrophage polarization to mitigate liver fibrosis, particularly in conditions such as hemochromatosis and chronic transfusion-dependent disorders.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"1200073"},"PeriodicalIF":2.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12658345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649815","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":"Response to Proton-Pump Inhibitors Therapy in Pediatric Patients With Eosinophilic Esophagitis in Bogotá, Colombia.","authors":"Andrea Estefanía Rodríguez López, José Fernando Vera Chamorro, Ailim Margarita Carias Domínguez, Mónica Viviana Pinilla Roncancio, Rocío Del Pilar López Panqueva, Gonzalo Andrés Montaño Rozo","doi":"10.1155/cjgh/4633813","DOIUrl":"10.1155/cjgh/4633813","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease and a leading cause of food impaction in pediatric populations, with potential functional and structural complications. Proton-pump inhibitors (PPIs) are widely used as first-line therapy, but the response rate in Colombian children remains unknown. This study aimed to determine the initial histologic response to PPI therapy and describe clinical, endoscopic, and histological characteristics in a sample of pediatric patients with EoE from Bogotá, Colombia.</p><p><strong>Methodology: </strong>A retrospective observational longitudinal study of patients aged 2-18 years diagnosed with EoE at a tertiary care center between 2015 and 2022 was conducted. Patients underwent initial clinical and endoscopic assessment confirming esophageal eosinophilia (≥ 15 eosinophils per high-power field [eos/hpf]), followed by at least 8-week course of PPI therapy and a subsequent clinical-endoscopic re-evaluation. Treatment response was defined histologically as < 15 eos/hpf in follow-up esophageal biopsy. Demographic, clinical, endoscopic, and histological data were analyzed using descriptive and bivariate statistics.</p><p><strong>Results: </strong>We included 34 patients (median age 11 years; 61.8% boys). Sixteen (47%) achieved histological remission with initial PPI therapy. Being esomeprazole preferred in 88%, with median dose 1.37 mg/kg/day. No significant differences were observed between responders and nonresponders in demographic variables, familial and personal atopic history, symptoms, or endoscopic findings. Histologically, responders demonstrated significant reductions in eosinophil counts, as well as improvements in basal zone hyperplasia, eosinophilic abscesses, and eosinophil surface layering (all <i>p</i> < 0.005).</p><p><strong>Discussion: </strong>This is the first study to assess PPI response in Colombian pediatric EoE patients, demonstrating a response rate consistent with existing literature. Histologic evaluation was identified as the most reliable marker of treatment success, underscoring the critical role of histopathological follow-up in this disease.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"4633813"},"PeriodicalIF":2.3,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641054","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":"Liver Histomorphological Changes in First- and Second-Generation Rat Offspring Associated With Maternal Undernutrition.","authors":"Renata Simkunaite-Rizgeliene, Rosita Reivytyte, Viktorija Virbauskyte, Ruta Vosyliute, Violeta Zalgeviciene, Violeta Bartuskiene, Ramune Cepuliene, Janina Tutkuviene","doi":"10.1155/cjgh/3752573","DOIUrl":"10.1155/cjgh/3752573","url":null,"abstract":"<p><strong>Background: </strong>Due to poverty and the pervasive thin-body ideal, undernutrition poses a significant challenge in both developed and economically undeveloped nations. Maternal nutritional deprivation has been linked to negative outcomes for the health of the fetus, a higher chance of metabolic syndrome, and adult obesity.</p><p><strong>Aim: </strong>Considering the functions of the liver, this study aims to assess the interface between maternal malnutrition and morphological changes of the liver in the first and second generations of aged offspring.</p><p><strong>Methods: </strong>This experimental study conducted in the Department of Anatomy, Histology, and Anthropology involved 26 rats divided into 3 groups: a control group fed a standard diet, a group subjected to 50% dietary restriction before pregnancy, and a group experiencing 50% dietary restriction before and during pregnancy. Histopathological examination was conducted on the livers of both first- and second-generation rat offspring to assess the occurrence of hepatic steatosis, ballooning, inflammation, and fibrosis. Data comparisons were performed using the Kruskal-Wallis test.</p><p><strong>Results: </strong>Both the first- and second-generation experimental groups displayed a more pronounced steatosis and ballooning index compared to the control group. In addition to this, both male and female progeny of the experimental groups exhibited higher levels of steatosis and ballooning. Offspring of mothers undernourished before pregnancy demonstrated a more severe case of steatosis, whereas offspring from mothers fed a low-calorie diet before and throughout pregnancy showed a higher ballooning index. In the second generation, these changes were less profound than those seen in the first generation. Notably, both experimental groups of the first generation exhibited significantly higher levels of steatosis compared to their equivalent second-generation counterparts.</p><p><strong>Conclusions: </strong>According to this study, there is a link between maternal undernutrition and a higher risk of nonalcoholic steatohepatitis or nonalcoholic fatty liver disease in the offspring's later life.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"3752573"},"PeriodicalIF":2.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12634871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589971","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}