Saudi Journal of Gastroenterology最新文献

{"title":"Using noninvasive clinical parameters to predict mortality and morbidity after cardiac interventions in patients with cirrhosis: A systematic review.","authors":"Christo Mathew, Ankur Patel, George Cholankeril, Avegail Flores, Ruben Hernaez","doi":"10.4103/sjg.sjg_263_23","DOIUrl":"10.4103/sjg.sjg_263_23","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease commonly affects advanced liver disease patients. They undergo cardiac interventions to improve cardiac outcomes. Cirrhosis increases complication risk, including bleeding, renal and respiratory failure, and further decompensation, including death, posing a clinical dilemma to proceduralists. Predicting outcomes is crucial in managing patients with cirrhosis. Our aim was to systematically review clinical parameters to assess the mortality and complication risk in patients with cirrhosis undergoing cardiac interventions.</p><p><strong>Methods: </strong>We searched cirrhosis and cardiovascular intervention terminology in PubMed and Excerpta Medica Database (EMBASE) from inception to January 8, 2023. We included studies reporting clinical scores (e.g. Model for End-stage Liver Disease (MELD), Child-Pugh-Turcotte (CPT), cardiovascular interventions, mortality, and morbidity outcomes). We independently abstracted data from eligible studies and performed qualitative summaries.</p><p><strong>Results: </strong>Eight studies met the inclusion criteria. Procedures included tricuspid valve surgery, catheterization-related procedures, aortic valve replacement (AVR), pericardiectomy, and left ventricular assist device (LVAD) placement. MELD primarily predicted mortality (n = 4), followed by CPT (n = 2). Mortality is significantly increased for MELD > 15 after tricuspid valve surgery. Albumin, creatinine, and MELD were significantly associated with increased mortality after transcatheter AVR (TAVR), although specific values lacked stratification. CPT was significantly associated with increased mortality after cardiac catheterization or pericardiectomy. In LVAD placement, increasing MELD increased the unadjusted odds for perioperative mortality.</p><p><strong>Conclusions: </strong>Our systematic review showed that clinical parameters predict mortality and morbidity risk in patients with cirrhosis undergoing cardiac procedures.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"14-22"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177631","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":"Construction of an enteral nutrition evaluation system for critically ill patients based on the Delphi method.","authors":"Yanrong Yao, Jingli Liu, Hongmei Xue, Xiaoyan Wang, Weijie Yao, Na Liu, Zuozheng Wang, Guangli Mi","doi":"10.4103/sjg.sjg_205_23","DOIUrl":"10.4103/sjg.sjg_205_23","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to construct an enteral nutrition evaluation system for critically ill patients using the Delphi method to direct the formulation of enteral nutrition support strategies and reduce interruption to enteral feeding.</p><p><strong>Methods: </strong>We used domestic and foreign databases to obtain and analyze the literature and form \"The Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients.\" The Delphi method was used to conduct two rounds of expert opinion consultation, combined with the suggestions from the research group to finalize the nutrition evaluation content of the system.</p><p><strong>Results: </strong>After two rounds of expert consultation, a nutrition evaluation system was formed around three dimensions: before the start, during, and after the end of nutritional support. The effective recovery rates of the two rounds of expert consultation were 90.0% (18/20) and 100.0% (18/18), respectively. Authority coefficients were 0.865 and 0.908, while Kendall coordination coefficients were 0.108 ( P < 0.05) and 0.115 ( P < 0.001), respectively. Finally, the full enteral nutrition evaluation system for critically ill patients was constructed based on the Delphi method, including three primary items and seven secondary and 28 tertiary indicators.</p><p><strong>Conclusion: </strong>The established \"Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients\" has high consistency from expert opinions and reliability, which can provide a practical evaluation tool for the process of enteral nutrition for severe patients.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"63-70"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291369","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":"Is IBD disk a reliable tool in Saudi Arabia?","authors":"Zahra A Al Saeed, Turki AlAmeel","doi":"10.4103/sjg.sjg_358_23","DOIUrl":"10.4103/sjg.sjg_358_23","url":null,"abstract":"","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"71"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720134","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":"Author response to \"Is IBD disk a reliable tool in Saudi Arabia?\"","authors":"Yaser Meeralam, Adnan B Al-Zanbagi, Mohammed K Shariff","doi":"10.4103/sjg.sjg_414_23","DOIUrl":"10.4103/sjg.sjg_414_23","url":null,"abstract":"","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"72"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058952","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":"Saudi consensus guidance for the management of inflammatory bowel disease during pregnancy.","authors":"Nahla A Azzam, Abdulelah Almutairdi, Hajer Y Almudaiheem, Turki AlAmeel, Shakir A Bakkari, Othman R Alharbi, Khalidah A Alenzi, Maha A AlMolaiki, Bedor A Al-Omari, Rayan G Albarakati, Ahmed H Al-Jedai, Omar I Saadah, Majid A Almadi, Badr Al-Bawardy, Mahmoud H Mosli","doi":"10.4103/sjg.sjg_318_23","DOIUrl":"10.4103/sjg.sjg_318_23","url":null,"abstract":"<p><strong>Abstract: </strong>The management of inflammatory bowel disease (IBD) in pregnant women is challenging and must be addressed on a patient-by-patient basis. Optimal patient management requires a multidisciplinary team and clear evidence-based recommendations that cater to this subset of patients. In this article, we provide concise guidelines and clinical care pathway for the management of IBD in pregnant women. Our recommendations were developed by a multidisciplinary working group that includes experts from the Saudi Ministry of Health in collaboration with the Saudi Gastroenterology Association and the Saudi Society of Clinical Pharmacology. All recommendations are based on up-to-date information following an extensive literature review. A total of 23 evidence-based expert opinion recommendations for the management of IBD in pregnant women are herein provided.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806006","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":"Vonoprazan-amoxicillin dual therapy for <i>Helicobacter pylori</i> eradication: A systematic review and meta-analysis of randomized controlled trials.","authors":"Ben-Gang Zhou, Yu-Zhou Mei, Xin Jiang, Ai-Jing Zheng, Yan-Bing Ding","doi":"10.4103/sjg.sjg_153_23","DOIUrl":"10.4103/sjg.sjg_153_23","url":null,"abstract":"<p><strong>Background: </strong>Vonoprazan-amoxicillin (VA) dual therapy has recently been proposed to eradicate Helicobacter pylori (H. pylori) with controversial results. We, therefore, conducted a meta-analysis to assess the effect of this therapy for H. pylori eradication.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, and Web of Science database from inception until November 2022, collecting randomized controlled trials (RCTs) comparing VA dual therapy with other regimens for H. pylori eradication. Pooled relative risks (RRs) were calculated using random effects model.</p><p><strong>Results: </strong>Five RCTs were ultimately included. Compared with the vonoprazan-amoxicillin-clarithromycin (VAC) triple therapy, the eradication rate of VA dual therapy was lower in intention-to-treat (ITT) analysis (n = 3 RCTs, RR = 0.94, 95% CI: 0.88-0.99, P = 0.03), but there was no significant difference between them in the per-protocol (PP) analysis (RR = 0.96, 95% CI: 0.91-1.01, P = 0.11). For clarithromycin-resistant H. pylori strains, the eradication rate of VA dual therapy was significantly higher than that of the VAC triple therapy (n = 2 RCTs, RR = 1.20, 95% CI: 1.03-1.39, P = 0.02). Compared with the PPI-based triple therapy (PAC), VA dual therapy had a superior eradication rate (n = 2 RCTs, ITT analysis: RR = 1.13, 95% CI: 1.04-1.23, P = 0.003; PP analysis: pooled RR = 1.14, 95% CI: 1.06-1.22, P = 0.0004). Compared with VAC or PAC triple therapy, VA dual therapy has a similar incidence of total adverse events and compliance.</p><p><strong>Conclusions: </strong>VA dual therapy had a similar effect compared to VAC triple therapy and was superior to PAC triple therapy. Future RCTs are needed to ascertain the optimal dosage and duration of vonoprazan and amoxicillin, and the effect of VA dual therapy compared with the mainstream regimens recommended by current guidelines.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":"29 6","pages":"347-357"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292083","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 and pathological characteristics of early-onset colorectal cancer in South Korea.","authors":"Su Bee Park, Jin Young Yoon, Min Seob Kwak, Jae Myung Cha","doi":"10.4103/sjg.sjg_35_23","DOIUrl":"10.4103/sjg.sjg_35_23","url":null,"abstract":"<p><strong>Background: </strong>Early-onset colorectal cancer (EOCRC) may differ by race and ethnicity, and recently South Korea has witnessed a surge in cases. We aimed to evaluate the clinical and pathological features of patients with EOCRC, and to determine the predictors of overall survival.</p><p><strong>Methods: </strong>In this retrospective study, EOCRC was defined as CRC diagnosed in patients aged < 50 years, and late-onset CRC was defined as CRC diagnosed in those over 75 years of age. The clinical and pathological characteristics of patients with EOCRC were compared with late-onset CRC. We also used multivariable Cox proportional hazard models to find predictors of overall survival in patients with EOCRC.</p><p><strong>Results: </strong>The proportion of early-onset CRC was 9.1% of 518 patients with CRC, and the clinical and pathological characteristics were similar between early-onset (n = 47) and late-onset CRC (n = 134). However, EOCRC had a preponderance for distal tumor location (70.2% vs. 50.7%, P = 0.02) and T1-2 stage disease (23.4% vs. 11.2%, P = 0.04), compared with those of late-onset CRC. Using multivariable Cox proportional hazard models, only vascular invasion (hazard ratio = 8.75, 95% confidence interval 1.139‒67.197) was found to be a risk factor for overall survival (P = 0.04) for patients with CRC.</p><p><strong>Conclusion: </strong>EOCRC had preponderance for distal tumor location and early T-stage disease, compared with late-onset CRC. Considering the increasing incidence of EOCRC, more studies on clinical and pathological characteristics of EOCRC may be warranted.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"358-364"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9835197","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":"Technique, sedation, and clinical outcome of endoscopic submucosal dissection for rectal tumor with involvement of dentate line: A retrospective cohort study.","authors":"Yoon Kyoo Noh, Jun Lee, Seong Jung Kim","doi":"10.4103/sjg.sjg_67_23","DOIUrl":"10.4103/sjg.sjg_67_23","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic submucosal dissection (ESD) of rectal tumors involving the dentate line (RT-DL) is challenging because of the anatomical features of the anal canal. This study aimed to identify optimal techniques and sedation and to determine the clinical outcomes of ESD for RT-DL.</p><p><strong>Methods: </strong>We retrospectively collected medical records and endoscopic results of patients who underwent ESD for rectal tumors between January 2012 and April 2021. Patients were divided into RT-DL and rectal tumors not involving the dentate line (RT-NDL) groups, as per involvement of the dentate line. The treatment results and clinical outcomes of the two groups were evaluated and analyzed. Additionally, subgroup analysis was performed in the RT-DL group for the sedation method involved.</p><p><strong>Results: </strong>In total, 225 patients were enrolled and 22 were assigned to the RT-DL group. The complete resection rate (90.9% vs. 95.6%, P =0.336), delayed bleeding (13.6% vs. 5.9%, P =0.084), perforation (0% vs. 3.9%, P = 0.343), hospital stays (4.55 vs. 4.48 days, P = 0.869), and recurrence (0% vs. 0.5%) showed no significant group differences. However, in RT-DL group, the procedure time (78.32 vs. 51.10 min, P = 0.002) was longer and there was more perianal pain (22.7% vs. 0%, P = 0.001). The subgroup analysis revealed that deep sedation using propofol reduced perianal pain during the procedure (0/14 vs. 5/8, P = 0.002).</p><p><strong>Conclusions: </strong>ESD of RT-DL is a safe and effective treatment despite the challenges of requiring a high level of technique and longer procedure time. In particular, ESD under deep sedation should be considered in patients with RT-DL to control perianal pain.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"365-370"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9577951","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":"Correlation between physician- and patient-directed disease assessments in ulcerative colitis patients from Saudi Arabia and Kuwait: Data from ICONIC.","authors":"Othman Al Harbi, Salem Owayed, Yousif Qari, Mahmoud Mosli, Ali Anwar, Alaa Masri, Mohamed Gouda, Ahmed Alfadhli","doi":"10.4103/sjg.sjg_92_23","DOIUrl":"10.4103/sjg.sjg_92_23","url":null,"abstract":"<p><strong>Background: </strong>The aim of the observational, prospective study was to validate a novel, nonverbal assessment tool for perceived disease burden-Pictorial Representation of Illness and Self-Measure (PRISM)-in ulcerative colitis (UC) against established patient health questionnaires. The cumulative burden of patients recently diagnosed (<3 years) with UC was also evaluated.</p><p><strong>Methods: </strong>\"ICONIC\" - Understanding the impact of ulcerative colitis and its associated disease burden on patients - was a noninterventional, multicountry, multicenter study performed in a 2-year follow-up format in adult patients with recently diagnosed UC in 33 countries, regardless of disease severity or treatment. Data collection consisted of five visits, scheduled at approximately 6-month intervals. For the current analysis, patient data from Saudi Arabia and Kuwait were evaluated. The collected data comprised demographics, disease-related data, UC treatment, and healthcare resources, as well as physician- and patient-assessed quality-of-life and disease burden questionnaires. Correlations between selected questionnaire scores were performed using Spearman's rho.</p><p><strong>Results: </strong>Disease severity at baseline and throughout the study was slightly less favorable in this country analysis compared with the global study cohort. Disease burden was assessed by PRISM and improved within 24 months.</p><p><strong>Conclusions: </strong>The detected moderate correlation between PRISM and other assessment methods supports the validity of PRISM. Differences in perceptions of UC-related burden between physician and patient may reflect to some degree insufficient patient-physician communication.</p>","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"381-387"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10081874","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":"Unlocking the path to efficient <i>H. pylori</i> eradication: Embracing potassium-competitive acid blockers (P-CABs).","authors":"Thomas J Borody, John Ng, Sibasish Dolai","doi":"10.4103/sjg.sjg_297_23","DOIUrl":"10.4103/sjg.sjg_297_23","url":null,"abstract":"","PeriodicalId":48881,"journal":{"name":"Saudi Journal of Gastroenterology","volume":" ","pages":"323-325"},"PeriodicalIF":2.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232048","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}