Canadian Journal of Gastroenterology and Hepatology最新文献

{"title":"Frequency and Outcomes of Acute-on-Chronic Liver Failure in Nonelective Cirrhotic Patients Admitted to a Brazilian ICU: A Single-Center Retrospective Study.","authors":"Maria Eduarda Chaves Soares, Liana Codes, Bianca Sampaio de Carvalho, Amanda Caroline Silveira E Silva, Myriam Sofia Angeli Guimarães de Oliveira, Fabiola Santos Sousa, Mariana Rebouças de Calasans, Jade de Oliveira Santana, Lucas Celes Dominguez, Paulo Lisboa Bittencourt","doi":"10.1155/cjgh/9728104","DOIUrl":"10.1155/cjgh/9728104","url":null,"abstract":"<p><p><b>Introduction:</b> Acute-on-chronic liver failure (ACLF) is a severe complication of cirrhosis characterized by acute decompensation (AD), organ failure(s), and high mortality. <b>Aims:</b> To investigate the frequency and the clinical course of ACLF in intensive care unit (ICU) patients at different time points, using CLIF-C and NACSELD criteria as well as to assess their influence on mortality. <b>Methods:</b> Patients admitted with AD with and without ACLF were retrospectively evaluated. <b>Results:</b> 595 patients (443 males, mean age: 66.6 ± 12.0 years) were admitted due to AD (<i>n</i> = 381) or ACLF (<i>n</i> = 214). According to the CLIF-C criteria, 119 patients (20%) had ACLF Grade I, 63 (10.6%) had ACLF Grade II, and 32 (5.4%) had ACLF Grade III at admission. Using the NACSELD, 155 patients (26.1%) had ACLF at admission. Infection was the main factor associated with ACLF at admission (<i>n</i> = 57; 27%, <i>p</i> = 0.001). In total, 104 (17.5%) patients died during hospitalization. ACLF grade at admission (OR: 4.6; 95% CI: 2.45-8.67; NS: 0.0001), use of vasopressors (OR: 3.83; 95% CI: 1.15-12.7; NS: 0.02), and CLIF-C ACLF (OR: 1.12; 95% CI: 1.06-1.19; NS: 0.0001) were independently associated with in-hospital mortality. The improvement in organ dysfunction after 7 days of intensive care was associated with a reduction in the risk of in-hospital mortality compared to the 3-day period (OR: 0.098; 95% CI: 0.047-0.204 vs. 0.253; 95% CI: 0.127-0.504; <i>p</i> < 0.00001, respectively). <b>Conclusion:</b> ACLF is associated with significant mortality in ICU patients, the CLIF-C criteria appear to be more effective for prognostic assessment than NACSELD, and 7 days of intensive care may improve clinical outcomes.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9728104"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201379","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":"Diagnostic Accuracy of the Faecal Immunochemical Test in Triage of Symptomatic Patients Referred for Colonoscopy: A Prospective Single-Centre Study.","authors":"T Matthews, M O'Sullivan, A Billur, F Janjua, A Aftab, F Zeb, G Courtney","doi":"10.1155/cjgh/2883395","DOIUrl":"10.1155/cjgh/2883395","url":null,"abstract":"<p><p><b>Aim:</b> The faecal immunochemical test (FIT) is endorsed by NICE for triaging symptomatic patients referred from primary care. This prospective diagnostic accuracy study assessed the performance of FIT in detecting significant colorectal pathology among symptomatic patients referred for colonoscopy in secondary care. <b>Method:</b> Between May 2023 and May 2024, FIT kits were distributed to 1296 adult patients referred for lower gastrointestinal (GI) endoscopy. A FIT threshold of ≥ 50 ng/mL prompted urgent colonoscopy; values < 50 ng/mL led to outpatient assessment unless Health Service Executive Priority 1 criteria were met. A complete colonoscopy served as the reference standard. <b>Results:</b> A total of 1113 patients (86%) returned valid FIT results; 215 (19%) were FIT positive. FIT-positive patients were significantly older than FIT-negative patients (58 vs. 54 years, <i>p</i> < 0.01). Among FIT-positive patients, 177 (82%) underwent colonoscopy, compared with 139 (15%) of FIT-negative patients. Colorectal cancer was detected in 20 FIT-positive patients and in none of the FIT-negative group, yielding a sensitivity and negative predictive value (NPV) of 100% (95% CI for sensitivity: 83-100 and NPV: 97-100). The area under the receiver operating characteristic (ROC) curve was 0.868 (95% CI: 0.82-0.91). For advanced polyps and inflammatory pathology, sensitivities were 77% and 89%, with NPVs of 98% for both. The mean time to endoscopy was shorter in FIT-positive patients (7 vs. 21 weeks, <i>p</i> < 0.01). <b>Conclusion:</b> FIT demonstrates excellent sensitivity for colorectal cancer and may serve as a safe, effective triage tool in symptomatic patients, helping optimise endoscopy services in resource-limited settings.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"2883395"},"PeriodicalIF":2.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975198","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":"Gastrointestinal Fistulas-What Gastroenterologists Need to Know in 2025.","authors":"Monjur Ahmed","doi":"10.1155/cjgh/6210421","DOIUrl":"10.1155/cjgh/6210421","url":null,"abstract":"<p><p>Gastrointestinal fistulas are increasingly being encountered in our clinical practice because of the increased burden of Crohn's disease, bariatric surgeries, interventional endoscopic procedures, nonsurgical trauma, and war and disaster zones worldwide. Presentation depends on the location and specific type of the fistula. Symptomatic ones can have a tremendous impact on social life and can cause dehydration, electrolyte imbalance, malnutrition, increased morbidity, and mortality. Different imaging studies and endoscopic procedures are done to establish the diagnosis. Treatment modalities to close the fistula depend on the underlying disease and the type of fistula. They include conservative treatment, medical therapy, endoscopic interventions, and surgery. Currently, there is no accepted treatment algorithm due to a lack of controlled clinical trials. The prognosis varies from fistula to fistula, and the mortality can be as high as 50%.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"6210421"},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975303","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":"Increased BMD in SLD Patients Without Advanced Hepatic Fibrosis: Evidence From the NHANES 2017-2020 Database.","authors":"Tianhao Wu, Lu Li, Yayuan Mei, Peizhen Lv, Jiawei Cui, Lin Liu, Yuemin Nan, Ang Li","doi":"10.1155/cjgh/6969761","DOIUrl":"10.1155/cjgh/6969761","url":null,"abstract":"<p><p><b>Background:</b> Recently, metabolic dysfunction-associated steatotic liver disease (MASLD) has been proposed to replace the liver condition previously known as nonalcoholic fatty liver disease (NAFLD), thereby redefining the subcategories of steatotic liver disease (SLD). However, the clinical relevance of SLD subcategories and their relationship with bone mass is lacking. In this study, we aimed to explore the potential association between the commonly proposed subclasses of fatty liver disease and bone mass. <b>Methods:</b> A cross-sectional study using the data from the 2017-2020 cycle of the National Health and Nutrition Examination Survey (NHANES), involving 4237 participants aged 18 years and older who underwent vibration-controlled transient elastography (VCTE) and dual-energy X-ray absorptiometry (DXA), was conducted. A weighted generalized linear model was used to analyze the association of the SLD subcategories and bone mass changes including bone mineral content (BMC), bone area, and bone mineral density (BMD) in the femur and spine, with adjustments for potential covariates. Furthermore, a weighted generalized additive model was employed to assess the dose-response relationships between controlled attenuation parameter (CAP), liver stiffness measurement (LSM), and BMD. <b>Results:</b> A total of 2635 and 1602 participants were included for analysis of the femur and lumbar spine, respectively. Compared to healthy individuals, positive correlations were observed between all three SLD subgroups (MASLD, MetALD, and ALD) and BMC, and BMD in the femur and spine, but no association with the bone area was identified. Moreover, CAP exhibited a strong positive correlation with BMD across all femoral and spinal scan sites. It was also positively correlated with BMC in some femoral scan sites and all spinal scan sites but was associated with the bone area only in certain femoral scan sites and not in spinal scan sites. In contrast, LSM showed clear positive correlations with BMD in some femoral and all spinal scan sites, as well as with BMC in certain femoral and spinal scan sites. However, LSM did not correlate with the bone area in any femoral or spinal scan sites. Besides, LSM showed a nonlinear association with these indicators. Subgroup analysis revealed a positive correlation between CAP and BMD only in individuals with CAP > 248 dB/m, BMI ≥ 25 kg/m², and LSM < 11.7 kPa. Additionally, in females and individuals with LSM < 11.7 kPa, LSM was positively correlated with BMD, whereas in those with LSM ≥ 11.7 kPa, LSM showed a negative correlation with BMD. <b>Conclusions:</b> Our findings highlighted a positive association between SLD and BMD; however, the association was likely influenced by liver fibrosis. Studies in large scale cohorts with a longer follow-up are warranted to elucidate the impacts of hepatic steatosis and associated pathologies on bone health.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"6969761"},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884136","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 Phenome-Wide Mendelian Randomization and Colocalization Study Reveals Genetic Association Between PBC and Other Autoimmune Disorders.","authors":"Shuyi Shi, Minghui Liu, Haonan Gao, Fang Liu, Yuhu Song","doi":"10.1155/cjgh/1716853","DOIUrl":"10.1155/cjgh/1716853","url":null,"abstract":"<p><p><b>Background:</b> Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease that is commonly associated with various other autoimmune disorders. We conducted a phenome-wide association study Mendelian randomization (MR-PheWAS) to determine genetic association between PBC and other diseases, particularly autoimmune disorders. <b>Methods:</b> We performed a PheWAS to investigate the causal associations between PBC and related traits by conducting enrichment analysis of 35 PBC risk loci identified by prior GWAS and their matched control SNP sets in UK Biobank database. MR-PheWAS and bidirectional two-sample Mendelian randomization analysis were conducted to determine causal association between PBC and hypothyroidism. Colocalization analysis was conducted to investigate common genetic variants with hypothyroidism. <b>Results:</b> Genetic liability to PBC was associated with a higher risk of 25 traits (hypothyroidism, asthma, allergic rhinitis, psoriasis, ulcerative colitis, and multiple sclerosis). After false discovery rate (FDR) correction, there exist 9 traits significantly difference. MR-PheWAS analysis demonstrated causal association between PBC and hypothyroidism, and bidirectional two-sample Mendelian randomization analysis was performed to validate it. The OR of hypothyroidism on PBC was 113.61(<i>p</i>=9.30E - 05), and PBC was also causally associated with hypothyroidism (OR: 1.005; <i>p</i>=4.33E - 09). Among the genes identified, CCDC88B and MMEL1 were found to have positive associations with the risk of hypothyroidism (CCDC88B: OR = 1.004, <i>p</i>=4.69E - 07; MMEL1: OR = 1.004, <i>p</i>=6.65E - 06) and FinnGen cohorts (CCDC88B: OR = 1.044; MMEL1: OR = 1.038). The two genes may be the drug targets for hypothyroidism (CCDC88B: coloc.abf-PPH4 = 94.7%; MMEL1: coloc.abf-PPH4 = 91.8%). <b>Conclusions:</b> Our study revealed genetic association between PBC and hypothyroidism through a phenome-wide Mendelian randomization, and then, colocalization identified two potential drug targets for hypothyroidism.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"1716853"},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734357","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":"Clinical Pathological Features and Carcinogenic Risk Factors of Colorectal Lateral Spreading Tumors With Skirt Features.","authors":"Longping Chen, Junguo Chen, Linfu Zheng, Jin Zheng, Binbin Xu, Dazhou Li, Wen Wang","doi":"10.1155/cjgh/9920606","DOIUrl":"10.1155/cjgh/9920606","url":null,"abstract":"<p><p><b>Objective:</b> This study aims to investigate the clinical pathological features of colorectal lateral spreading tumors (LSTs) with skirt features and the associated carcinogenic risk factors. <b>Methods:</b> A total of 390 cases of colorectal LSTs, treated via endoscopy at the Digestive Endoscopy Center of the 900th Hospital of the People's Liberation Army Joint Logistics Support Force between January 2021 and August 2023, were included. The cases were categorized into a skirt group (30 cases) and a group without a skirt (360 cases) based on the presence of skirt features. The clinical pathological characteristics, including age, gender, endoscopic features (lesion diameter, location, morphology), and histological types, were compared between the two groups. Additionally, the risk factors for carcinogenesis in LSTs with a skirt were analyzed. <b>Results:</b> Among the 390 LSTs cases, 30 (7.69%) exhibited skirt features, with 23 lesions located in the rectum (76.67%) and 26 lesions having a diameter of ≥ 20 mm (86.67%). Histological classification revealed 10 cases (33.33%) of adenomas with low-grade intraepithelial neoplasia (LGIN), 9 cases (30.00%) of adenomas with high-GIN (HGIN), and 11 cases (36.67%) of carcinoma. The proportions of female patients, rectal lesions, lesions with a diameter of ≥ 20 mm, mixed nodular lesions, and those classified as carcinoma were significantly higher in LSTs with a skirt group compared to LSTs without a skirt group. Rectal lesions (<i>p</i>=0.001, OR = 8.588, 95% CI: 2.428-30.379) and lesion diameters ≥ 20 mm (<i>p</i>=0.008, OR = 4.538, 95% CI: 1.477-13.940) were identified as independent predictors of skirt presence in colorectal LSTs. Age ≥ 60 years (<i>p</i>=0.002, OR = 22.667, 95% CI: 3.140-163.629) was found to be an independent risk factor for carcinogenesis in LSTs with a skirt. <b>Conclusion:</b> Compared with LSTs without a skirt, the results indicated that LSTs with a skirt are more commonly found in female patients, predominantly has a diameter of ≥ 20 mm, typically presents as a mixed nodular type, is frequently located in the rectum, and is often classified as carcinoma. The presence of rectal lesions and lesion diameter ≥ 20 mm increases the likelihood of skirt features in LSTs. Furthermore, advanced age (≥ 60 years) may elevate the risk of carcinogenesis in LSTs with a skirt, necessitating thorough preoperative assessments and complete resection during endoscopic removal of such lesions.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9920606"},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327451","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":"Acute Toxicity Assessment, In Vitro Antacid and Cytoprotective Effects of Root Bark Aqueous Extract of <i>Diospyros mespiliformis</i> on Water Immersion Stress-Induced Gastric Ulcers in Rats.","authors":"Vandza Luc Vandi, André Perfusion Amang, Christophe Mezui, Gael Tchokomeni Siwe, Odile Baponwa, Sidiki Aboubakar, Joseph Fleurie Emakoua, Paul Vernyuy Tan","doi":"10.1155/cjgh/8936445","DOIUrl":"10.1155/cjgh/8936445","url":null,"abstract":"<p><p><b>Objective:</b> The objective of the present study was to evaluate the antacid and cytoprotective effects of root bark aqueous extract of <i>Diospyros mespiliformis</i> (RBAEDM). <b>Materials and Methods:</b> Thirty rats were grouped into six groups of five rats each, namely, three control groups (normal, negative and positive) and three test groups. These animals were treated with distilled water (normal and negative controls), verapamil (positive control) and the extract at doses of 100, 200 and 400 mg/kg (test groups). One hour after treatment, gastric ulcers were induced in all animals by immersion in water (22 ± 1°C) for 5 h except for the normal control. The ulcerated surface, mucus mass, in vivo oxidative stress parameters and nitrite levels were determined. In vitro antacid activity of the extract was evaluated on artificial gastric juice by the determination of pH, neutralization time and antacid capacity. Acute toxicity of extract was evaluated. <b>Results:</b> Treatment with RBAEDM showed a significant (<i>p</i> < 0.01, <i>p</i> < 0.001) decrease of ulcerated surface with a percentage of inhibition between 5.58% and 60.46%. The decrease in the ulcerated surface was accompanied by a significant (<i>p</i> < 0.001) increase in mucus production at 400 mg/kg. Treatment with RBAEDM also showed a significant (<i>p</i> < 0.001) decrease in malondialdehyde (MDA) levels and a significant increase in superoxide dismutase (SOD) level, catalase (CAT) activities, in addition to nitrite levels in stomachs. In artificial gastric juice, the RBAEDM caused a significant increase (<i>p</i> < 0.001) of neutralizing time and the number of neutralized H⁺ ions compared to distilled water. No change in behavioural parameters and no death was observed after administration of the extract at 2000 mg/kg. <b>Conclusion:</b> RBAEDM inhibited ulcer occurrence by the stimulation of mucus production, increase of antioxidant enzyme activity and NO production. Moreover, this study revealed that the studied extract could exert a strong anti-acid capacity in vitro due its ability for the neutralization of H⁺ ions. DL₅₀ of RBAEDM was greater than 2000 mg/kg.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"8936445"},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303379","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":"Association Between Older Age and TIPS-Related Hospitalization Following Shunt Placement.","authors":"Matthew Schliep, Brian J Wentworth, Indira Bhavsar-Burke, Anthony Rainho, Megha Chiruvella, Matthew J Stotts, Marwan Ghabril","doi":"10.1155/cjgh/8894058","DOIUrl":"10.1155/cjgh/8894058","url":null,"abstract":"<p><p><b>Background and Aims:</b> Patients experience more complications of portal hypertension as liver disease progresses, many of which can be managed by transjugular intrahepatic portosystemic shunt (TIPS) insertion. Controversy surrounds the association of age with TIPS-related complications. We sought to evaluate the effect of age on TIPS-associated outcomes, including hospital admissions. <b>Methods:</b> This retrospective, bicentric cohort study included patients who underwent TIPS insertion between January 1, 2006, and December 31, 2016. The primary outcome of the study was predictors of liver-related hospital admission within 12 months of TIPS insertion between patients < 70 years and ≥ 70 years old. Secondary outcomes included mortality at 12 months and MELD-Na score at 90 days following TIPS placement. <b>Results:</b> A total of 593 patients were included in the study-487 patients were less than 70 years old while 106 patients were 70 years of age or older. Near equal percentages of elderly and nonelderly patients were admitted with post-TIPS complications within 12 months of insertion (29.2% v. 29.0%, <i>p</i>=0.91). Pre-existing diagnoses of diabetes and/or hypertension, hepatic hydrothorax, as well as serum creatinine and/or serum sodium at the time of TIPS insertion were associated with TIPS-related admissions within the first 12 months of shunt insertion. <b>Conclusion:</b> TIPS placement in selected older patients can be safe. Age should not be a strict contraindication for TIPS insertion, but discussion regarding risks and benefits of the procedure should be individualized.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"8894058"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175394","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 Early Albumin Use for Resuscitation in Patients With Septic Shock and Cirrhosis.","authors":"Hannah M Brinkman, Kianoush B Kashani, Alice Gallo de Moraes, Kristin C Cole, Douglas A Simonetto, Andrea M Nei","doi":"10.1155/cjgh/8637440","DOIUrl":"10.1155/cjgh/8637440","url":null,"abstract":"<p><p><b>Background:</b> The choice of resuscitation fluid remains debated for patients with septic shock. While patients with cirrhosis may benefit from albumin administration, the efficacy of albumin for resuscitation in cirrhotic patients with septic shock remains unclear. <b>Methods:</b> This is a historical cohort study of patients with cirrhosis admitted for septic shock to the intensive care unit (ICU) at a tertiary referral hospital from January 2007 to May 2017. Patients were stratified based on using albumin for fluid resuscitation within six hours of ICU admission. The primary outcome was the percentage of time during the first 48 h of ICU admission that patients were alive and shock-free. Linear regression was used to compare this outcome between groups, and a multivariable analysis was performed to account for baseline differences between study populations. <b>Results:</b> Of the 132 patients with cirrhosis admitted for septic shock, albumin was administered within the first six hours of ICU admission for 84 patients (64%). The albumin and nonalbumin groups had similar percentages of shock-free time during the first 48 h of ICU admission (9.0% vs. 20.2%, <i>p</i> = 0.073) and ICU length of stay (5.6 vs. 3.7 days, <i>p</i> = 0.093). No differences were observed in clinical outcomes of end-organ dysfunction, such as the need for kidney replacement therapy or mechanical ventilation. <b>Conclusion:</b> Administration of albumin during the first 6 h of ICU admission as an adjunctive resuscitation fluid to crystalloids was not associated with improved shock-free time in the ICU or clinical outcomes in patients with cirrhosis and septic shock.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"8637440"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095384","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":"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":2.3,"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}