{"title":"Low Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) Ratio Associated with Increased Cardiovascular Disease and its Risk Factors in Healthy Japanese Population.","authors":"Michiaki Higashitani, Atsushi Mizuno, Takeshi Kimura, Takuro Shimbo, Kazuki Yamamoto, Sayuri Tokioka, Daiki Kobayashi","doi":"10.15403/jgld-4446","DOIUrl":"https://doi.org/10.15403/jgld-4446","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to evaluate the association between aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and cardiovascular disease, and risk factors in a healthy Japanese population.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at St. Luke's International Hospital, Tokyo, Japan, between 2005 and 2018. We included all participants who visited the hospital for voluntary health checkups. Our primary outcome was the development of cardiovascular disease, and the secondary outcomes were cardiovascular risk factors. We grouped the participants into quartiles (Qs) according to their baseline AST/ ALT ratios and examined the outcomes of patients in each group.</p><p><strong>Results: </strong>87,740 participants were included in this study. The mean age of the participants was 44.9 years [standard deviation (SD): 12.1], and 43,191 (49.2%) were men. The mean AST and ALT levels were 21.7 IU/L (SD 10.0) and 22.4 IU/L (SD 16.5), respectively, resulting in a mean AST/ALT ratio of 1.1 (0.4). During the median follow-up of 1,829 days (interquartile range 756-3,470), 1,493 (1.7%) participants developed cardiovascular disease, 831 (1%) experienced ischemic heart disease, and 723 (0.8%) experienced strokes. Those in the Q1 AST/ALT ratio group had significantly higher hazard ratios compared to those in the Q3 AST/ ALT ratio group [adjusted hazard ratio (HR)=1.32, 95% confidence interval (CI): 1.12-1.56 for cardiovascular disease; HR=1.36, 95%CI: 1.09-1.68 for ischemic heart disease; HR=1.28, 95%CI: 1.00-1.65 for stroke]. However, those belonging to the Q4 or Q5 AST/ALT ratio groups was not statistically different for primary outcomes compared to the Q3 AST/ALT ratio group. In contrast, the adjusted HRs for all secondary outcomes decreased in a dose-dependent manner as the AST/ALT ratio increased.</p><p><strong>Conclusions: </strong>A Q1 AST/ALT ratio was associated with an increased risk of cardiovascular disease compared to the Q3 AST/ALT ratio in the Japanese population, which is in contrast with the Western population. In our study, Q4 or Q5 AST/ALT ratios were not associated with cardiovascular disease compared to the Q3 AST/ ALT ratio. As for cardiovascular risk factors, the risk decreased as the AST/ALT ratio increased.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"429-436"},"PeriodicalIF":2.1,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10746800","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}
Mariapaola Piazzolla, Antonia Valeria Borraccino, Salvatore Rizzi, Giuseppe Losurdo, Alfredo Di Leo
{"title":"Jejunal venous malformations in Cowden syndrome: a case report.","authors":"Mariapaola Piazzolla, Antonia Valeria Borraccino, Salvatore Rizzi, Giuseppe Losurdo, Alfredo Di Leo","doi":"10.15403/jgld-4655","DOIUrl":"https://doi.org/10.15403/jgld-4655","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"480-481"},"PeriodicalIF":2.1,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10755881","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}
Dario Gambaccini, Luigi Ruggiero, Emanuele Marciano
{"title":"Cholangioscopy in Recurrent Cholangitis after Liver Transplantation: Selective Guidewire Cannulation of Non-anastomotic Biliary Stricture.","authors":"Dario Gambaccini, Luigi Ruggiero, Emanuele Marciano","doi":"10.15403/jgld-4552","DOIUrl":"https://doi.org/10.15403/jgld-4552","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"381"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10746796","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":"Endoscopic Balloon Dilation of a Pyloric Stricture Caused by Sarcina Ventriculi Infection.","authors":"Isabel Garrido, Eduardo Rodrigues-Pinto, Irene Gullo, Guilherme Macedo","doi":"10.15403/jgld-4505","DOIUrl":"https://doi.org/10.15403/jgld-4505","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"380"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10746797","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":"Nurse Practitioners in Inflammatory Bowel Disease: The Emerging Role of the IBD Care Manager.","authors":"Daniele Napolitano, Elisa Schiavoni, Franco Scaldaferri","doi":"10.15403/jgld-4627","DOIUrl":"https://doi.org/10.15403/jgld-4627","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"4627"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10755878","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":"A Case of an Incidentally Identified Esophageal Perforation due to Food Impaction during a Screening Examination.","authors":"Koichi Soga","doi":"10.15403/jgld-4562","DOIUrl":"https://doi.org/10.15403/jgld-4562","url":null,"abstract":"","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"379"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10755879","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":"Acceptability of Hybrid Endoscopic Submucosal Dissection Using Multifunctional Snare for Small-sized Gastric Neoplasms: A Prospective Observational Study.","authors":"Taiga Chiyo, Hideki Kobara, Noriko Nishiyama, Kaho Nakatani, Naoya Tada, Kazuhiro Koduka, Takanori Matsui, Nobuya Kobayashi, Shintaro Fujihara, Tatsuo Yachida, Tsutomu Masaki","doi":"10.15403/jgld-4524","DOIUrl":"https://doi.org/10.15403/jgld-4524","url":null,"abstract":"<p><strong>Background and aims: </strong>The most suitable procedure for resecting small-sized gastric neoplasms remains unclear. Endoscopic mucosal resection leads to non-curative resection owing to slippage of the snare, and technically difficult endoscopic submucosal dissection (ESD) is instrumentally uneconomical. A novel, cost-effective, multifunctional snare called SOUTEN is available as a hybrid ESD (h-ESD) device developed for facilitating ESD. This study aimed to assess the acceptability of h-ESD using the SOUTEN for resecting small-sized gastric neoplasms.</p><p><strong>Methods: </strong>This was a prospective observational study conducted at our single institution between March 2019 and March 2021. Fifty-seven consecutive patients who underwent h-ESD using SOUTEN for small-sized gastric neoplasms ≤15 mm involving adenoma and tubular-type mucosal carcinoma without ulceration were enrolled. The primary outcome was curative resection rate for h-ESD. Secondary outcomes were the rates of conversion to ESD, rate of total (h-ESD + ESD) curative resection, procedure time, rates of intra-and post- operative complications, and presence of additional knives excluding hemostatic forceps.</p><p><strong>Results: </strong>The curative resection rate of h-ESD was 89.5% (51/57). The total (h-ESD + ESD) curative resection rate was 94.7% (54/57). The mean procedure time was 21.2 (±16.5) minutes. One case of delayed bleeding occurred. Additional knives were applied in two cases.</p><p><strong>Conclusions: </strong>The cost-efficient h-ESD using SOUTEN can be an acceptable procedure for resecting small- sized gastric neoplasms.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"390-395"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10755872","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}
Antonio Tursi, Giammarco Mocci, Antonio Cuomo, Antonio Ferronato, Walter Elisei, Marcello Picchio, Giovanni Maconi, Franco Scaldaferri, Alfredo Papa, Leonardo Allegretta, Giovanni Aragona, Maria Antonia Bianco, Raffaele Colucci, Nicola Della Valle, Roberto Faggiani, Giacomo Forti, Federica Gaiani, GianMarco Giorgetti, Maria Giovanna Graziani, Katia Lofano, Roberto Lorenzetti, Tiziana Larussa, Antonio Penna, Gabrio Bassotti, Alessia Immacolata Cazzato, Stefania Chiri, Valeria Clemente, Andrea Cocco, Gianluigi De' Angelis, Laura Donnarumma, Camilla Graziosi, Marco Le Grazie, Francesco Luzza, Costantino Meucci, Rita Monterubbianesi, Cristiano Pagnini, Patrizia Perazzo, Roberta Pica, Giuseppe Pranzo, Stefano Rodino', Rodolfo Sacco, Ladislava Sebkova, Antonella Scarcelli, Mariaelena Serio, Daniele Napolitano, Daniela Pugliese, Elisa Schiavoni, Laura Turchini, Alessandro Armuzzi, Costantino Zampaletta
{"title":"Replacement of Adalimumab Originator to Adalimumab Biosimilar for a Non-Medical Reason in Patients with Inflammatory Bowel Disease: A Real-life Comparison of Adalimumab Biosimilars Currently Available in Italy.","authors":"Antonio Tursi, Giammarco Mocci, Antonio Cuomo, Antonio Ferronato, Walter Elisei, Marcello Picchio, Giovanni Maconi, Franco Scaldaferri, Alfredo Papa, Leonardo Allegretta, Giovanni Aragona, Maria Antonia Bianco, Raffaele Colucci, Nicola Della Valle, Roberto Faggiani, Giacomo Forti, Federica Gaiani, GianMarco Giorgetti, Maria Giovanna Graziani, Katia Lofano, Roberto Lorenzetti, Tiziana Larussa, Antonio Penna, Gabrio Bassotti, Alessia Immacolata Cazzato, Stefania Chiri, Valeria Clemente, Andrea Cocco, Gianluigi De' Angelis, Laura Donnarumma, Camilla Graziosi, Marco Le Grazie, Francesco Luzza, Costantino Meucci, Rita Monterubbianesi, Cristiano Pagnini, Patrizia Perazzo, Roberta Pica, Giuseppe Pranzo, Stefano Rodino', Rodolfo Sacco, Ladislava Sebkova, Antonella Scarcelli, Mariaelena Serio, Daniele Napolitano, Daniela Pugliese, Elisa Schiavoni, Laura Turchini, Alessandro Armuzzi, Costantino Zampaletta","doi":"10.15403/jgld-4608","DOIUrl":"https://doi.org/10.15403/jgld-4608","url":null,"abstract":"<p><strong>Background and aims: </strong>Adalimumab (ADA) biosimilars have been included into the therapeutic armamentarium of inflammatory bowel disease (IBD); however, comparative data on the efficacy and safety of the different ADA biosimilars after replacing the ADA originator for a non-medical reason remains scarce. We aimed to compare in a real-life setting the efficacy and safety of four ADA biosimilars SB5, APB501, GP2017, and MSB11022 in IBD patients after replacing the originator for a non-medical reason.</p><p><strong>Methods: </strong>A multicenter retrospective study was performed on consecutive IBD patients, analyzing clinical, laboratory, and endoscopic data. The primary endpoints of the study were maintenance of clinical remission and safety of the different biosimilars.</p><p><strong>Results: </strong>153 patients were enrolled, 26 with UC and 127 with CD. Clinical remission was maintained in 124 out of 153 (81%) patients after a median (IQR) follow-up of 12 (6-24) months, without any significant difference between the four ADA biosimilars. ADA biosimilars dosage was optimized in five patients (3.3%). Loss of remission was significantly higher in UC patients (10/26 patients, 38.5%) than in CD patients (19/127 patients, 14.9%, p<0.025). Adverse events occurred in 12 (7.9%) patients; the large majority were mild.</p><p><strong>Conclusions: </strong>No difference in efficacy and safety was found between ADA biosimilars when used to replace the ADA originator for a non-medical reason. However, in UC patients the replacement of ADA originator for this reason should be carefully assessed.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"411-416"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10746804","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}
Aida Puia, Diana Schlanger, Alin Fetti, Calin Popa, Alexandru Necula, Nadim Al Hajjar
{"title":"Do Patient Delay and Diagnostic Delay Influence Long Term Survival in Patients with Gastric Cancer?","authors":"Aida Puia, Diana Schlanger, Alin Fetti, Calin Popa, Alexandru Necula, Nadim Al Hajjar","doi":"10.15403/jgld-4486","DOIUrl":"https://doi.org/10.15403/jgld-4486","url":null,"abstract":"<p><strong>Background and aims: </strong>Gastric cancer is one of the most common malignancies, with an aggressive evolution and a poor long-term prognosis. No screening program is available in Europe for this pathology; therefore, the delay from the appearance of the first symptom until the initiation of treatment might influence the prognosis of gastric cancer patients. We aimed to investigate the impact on the prognosis of the delay in the presentation and diagnosis in patients with gastric adenocarcinoma.</p><p><strong>Methods: </strong>Our study is a retrospective, single-center, observational cohort study, based on patients diagnosed with gastric adenocarcinoma and operated in our institution between 2013 and 2021. We have defined patient delay as the time from the onset of symptoms to the first encounter with a health care provider and diagnosis delay as the time from the first consultation with a health care provider to the establishment of the final diagnosis.</p><p><strong>Results: </strong>A total of 671 patients were included in our study. The survival rate at 5 years was 55% for the patients operated with curative intent and 7.4% for the patients operated with palliative intent. Patient delay and diagnosis delay were not correlated with the overall survival. A lower survival was observed for patients admitted through transfer (p<0.001) or the emergency department (p<0.001). No statistically significant relationship was identified between patient delay or diagnosis delay and the age, gender or area of origin of patients. Patients that experienced melena or hematemesis had a shorter patient delay, with a highly significant statistical relationship (p<0.01). Patients that experienced nausea, epigastric pain, palpable epigastric tumor mass or anorexia also had a highly significant statistical relationship between the symptoms and the patient delay interval.</p><p><strong>Conclusions: </strong>The overall survival is not influenced by the patient delay or diagnosis delay. An earlier presentation was correlated with some specific exhibited symptoms: upper gastro-intestinal bleeding, abdominal pain, palpable epigastric tumor, nausea.</p>","PeriodicalId":50189,"journal":{"name":"Journal of Gastrointestinal and Liver Diseases","volume":"31 4","pages":"396-402"},"PeriodicalIF":2.1,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10746802","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}