Advances in Digestive Medicine最新文献

{"title":"An unusual subepithelial tumor of gastritis cystica profunda","authors":"Kai‐Jie Lin, H. Shih, Yu‐Chung Hsu, Yi-Hsun Chen","doi":"10.1002/aid2.13411","DOIUrl":"https://doi.org/10.1002/aid2.13411","url":null,"abstract":"","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of radiation exposure in endoscopic ultrasound‐guided drainage versus endoscopic transpapillary drainage for acute cholecystitis","authors":"Koichiro Mandai, Takato Inoue, Shiho Nakamura, Takaaki Yoshimoto, Tomoya Ogawa, K. Uno, K. Yasuda","doi":"10.1002/aid2.13400","DOIUrl":"https://doi.org/10.1002/aid2.13400","url":null,"abstract":"Currently, reports comparing radiation exposure associated with endoscopic transpapillary gallbladder drainage (ETGBD) and endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) for acute cholecystitis are lacking. Therefore, we aimed to evaluate the radiation exposure during ETGBD and EUS‐GBD. We retrospectively investigated patients with acute cholecystitis who underwent ETGBD or EUS‐GBD between January 2020 and September 2023. All procedures were performed using the same fluoroscopy device with an overcouch x‐ray tube. Parameters such as fluoroscopy time, number of radiographs, and estimated entrance surface dose were assessed for radiation exposure. After excluding patients with choledocholithiasis or acute cholangitis, a comparative analysis of patient characteristics and procedural outcomes was performed between the ETGBD and EUS‐GBD groups. Forty‐four patients (21 and 23 in the ETGBD and EUS‐GBD groups, respectively) were assessed. Although there was no significant difference in patients with an American Society of Anesthesiologists physical status ≥3 between the groups, the EUS‐GBD group had a higher proportion of older patients than the ETGBD group. The EUS‐GBD group demonstrated a shorter procedure time (38 vs. 59 min, p < .001), shorter fluoroscopy time (964 vs. 1829 s, p < .001), fewer radiographs (22.9 vs. 28.4 images, p < .001), and lower estimated entrance surface dose (85.2 vs. 149.3 mGy, p < .001) compared to the ETGBD group. The EUS‐GBD group had a higher procedural success rate than the ETGBD group (100% vs. 57.1%, p < .001), with no significant difference in the incidence of early adverse events (17.4% vs. 9.5%, p = .67). In patients with permanent stenting, the 1‐year cumulative incidence of symptomatic late adverse events (recurrence of acute cholecystitis and other adverse events) was significantly lower in the EUS‐GBD group than in the ETGBD group (p = .045). In patients without concurrent bile duct stones or cholangitis, EUS‐GBD demonstrated shorter procedure and fluoroscopy times, required fewer radiographs, and had a significantly higher procedural success rate than ETGBD.","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High recurrence of reflux symptoms following proton pump inhibitor therapy discontinuation in patients with Los Angeles grade A/B erosive esophagitis: What is the next step?","authors":"Ming-Wun Wong,&nbsp;Chien-Lin Chen","doi":"10.1002/aid2.13422","DOIUrl":"10.1002/aid2.13422","url":null,"abstract":"<p>Gastroesophageal reflux disease (GERD) exhibits a global prevalence ranging from 8% to 33%.<span>¹</span> Esophagogastroduodenoscopy serves as a crucial diagnostic tool for providing objective evidence of GERD, such as erosive esophagitis and Barrett's esophagus, and for excluding other potential causes. It is the preferred initial modality for GERD surveillance as mandated by the national health insurance policy in Taiwan.<span>²</span> GERD diagnosis is typically established through a synthesis of clinical, endoscopic, and physiological criteria, as recently outlined in the Lyon Consensus 2.0. GERD is conclusively diagnosed based on the endoscopic evidence of esophagitis (Los Angeles grades B, C, and D), Barrett's esophagus, or peptic stricture. Additionally, a diagnosis of GERD can be confirmed by acid exposure time (AET) exceeding 6% during pH impedance testing, or over 2 days with AET exceeding 6% as determined by wireless pH monitoring.<span>²</span></p><p>Symptomatic relapse frequently occurs swiftly among patients with GERD symptoms following the discontinuation of treatment. Previous prospective studies have indicated that up to 30.4% of GERD patients experience symptom recurrence within the first year of follow-up, with symptom recurrence associated with the initial symptom burden.<span>³</span> A severe GERD phenotype, characterized by advanced-grade esophagitis (Los Angeles grade C or D), and/or AET exceeding 12.0%, or a DeMeester score greater than 50, has been identified. Management of this phenotype often necessitates continuous long-term proton pump inhibitor (PPI) therapy or invasive anti-reflux procedures, alongside lifestyle optimization.<span>⁴</span> According to the AGA clinical practice update on a personalized approach to GERD evaluation and management, clinicians should assess the appropriateness and dosing of PPI therapy within 12 months of initiation for patients with unproven GERD, and should consider offering endoscopy along with prolonged wireless reflux monitoring off PPI therapy to validate the long-term use of PPIs.<span>⁴</span> In this context, it is recommended that endoscopy coupled with prolonged reflux monitoring be ideally conducted after withholding PPI therapy for 2 to 4 weeks, whenever feasible.<span>⁵</span> This approach is vital for shared decision-making, as it helps patients understand the necessity for potential chronic lifelong maintenance therapy.<span>⁴</span></p><p>Shih et al. have demonstrated that within a 12-week period following the initial administration of PPIs, the cumulative incidence of symptom relapse among patients diagnosed with Los Angeles grade A and B erosive esophagitis can reach up to 50.2%. Additionally, advanced age and smoking have been identified as independent predictors of symptom relapse. This study underscores the significant reliance on PPIs even among patients with mild erosive ","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-onset gastric cancer: A distinct reality with significant implications","authors":"Hsu-Heng Yen","doi":"10.1002/aid2.13421","DOIUrl":"10.1002/aid2.13421","url":null,"abstract":"<p>In recent years, epidemiological studies found a notable change in the occurrence and prevalence of certain types of digestive system malignancies. Specifically, there is a shift in these cancers being diagnosed at a younger age, which is commonly referred to as “early-onset cancer.” This is especially noticeable in colorectal cancer and to a lesser extent in other malignant digestive tumors, primarily in the gastric and to a lesser extent in the pancreas and biliary tract.<span>¹</span> In this issue, Tran<span>²</span> et al described the clinical and endoscopic characteristics of this group of individuals from a Vietnamese population. Nine percent of the study population were categorized as early-onset gastric cancer (EOGC), with a diagnosis occurring before the age of 40.</p><p>Approximately 90% of gastric cancer is attributable to <i>Helicobacter pylori (H. pylori)</i> infection, and the global incidence of gastric cancer declined in both male and female individuals globally, like the declining trend of <i>H. pylori</i> prevalence.<span>³</span> However, the incidence of EOGC increased and now comprises 30% of gastric cancer<span>^{4, 5}</span> in the United States. Only a minority of them are being associated with a genetic disease such as the hereditary diffuse gastric cancer or the Lynch syndromes and the remaining majority being sporadic.<span>⁶</span> Higher prevalence of alcohol drinking and unhealthy dietary habits but not smoking are associated with higher prevalence of EOCG.<span>⁷</span> EOGC is predominantly found in the stomach body and is more prone to manifesting as a diffuse infiltrative pattern.<span>²</span> A higher proportion of early-onset gastric cancers were associated with an unfavorable tumor biology and advanced stage at presentation compared with those that occur later in life.<span>^{2, 5, 6}</span></p><p>The identification of gastric cancer in young adults poses a considerable difficulty from both personal and societal viewpoints, especially due to the unfavorable prognosis linked to this ailment. The absence of recommendations for screening for these younger population hinders early detection.<span>⁸</span> Screening endoscopy is the main technique employed for early detection and curative resection of gastric cancer.<span>^{9, 10}</span> A trained endoscopist must thoroughly prepare the endoscope by employing defoamers and mucolytics and examine the stomach body to identify any infrequently overlooked anomalies, such as pale or depressed patches.<span>²</span></p><p>In conclusion, EOGC presents unique challenges due to its nonspecific symptoms and rapid disease progression.<span>²</span> Prior research has demonstrated that eliminating <i>H. pylori</i> infection reduces the occurrence and death rate of gastric cancer.<span>¹¹</span> Further investigation is required to identify","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13421","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of hepatitis A spread in Syria—A call for awareness and prevention","authors":"Nour abd allatif Saoud, Moatasem Hussein Al-janabi","doi":"10.1002/aid2.13408","DOIUrl":"https://doi.org/10.1002/aid2.13408","url":null,"abstract":"","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggravated pancreatitis after performing a colonoscopy","authors":"Han‐Lin Liao, Tyng-Yuang Jang","doi":"10.1002/aid2.13409","DOIUrl":"https://doi.org/10.1002/aid2.13409","url":null,"abstract":"","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of serum WFA+‐M2BP, FIB‐4, and APRI for cirrhosis and esophageal varices prediction in hepatoma patients","authors":"Ming‐Tsung Lin, Kuo-Chin Chang, Chih‐Chi Wang, Sherry Yueh‐Hsia Chiu, C. Yong, Yueh-Wei Liu, Wei-Feng Li, Jing-Houng Wang, Chao-Cheng Huang, Chang‐Chun Hsiao, Ming‐Hong Tai, Tsung‐Hui Hu","doi":"10.1002/aid2.13369","DOIUrl":"https://doi.org/10.1002/aid2.13369","url":null,"abstract":"Wisteria floribunda agglutinin‐positive Mac‐2 binding protein (WFA+‐M2BP) is a novel biomarker for evaluating hepatic fibrosis and hepatocellular carcinoma (HCC) development. However, no previous study has compared its diagnostic accuracy with that of FIB‐4 or APRI nor explored its clinical application for predicting esophageal varices bleeding in HCC patients. In this study, we explored these biomarkers and compared their clinical roles. Total 459 HCC patients who underwent curative operation were enrolled in this study. WFA+‐M2BP level was evaluated using stored blood samples that were collected during surgery, and liver fibrosis was diagnosed based on findings of surgical specimen analysis. Esophageal or gastric varices were evaluated in 207 patients who underwent esophagogastroduodenoscopy (EGD). The correlation between the markers was also determined. Our study showed WFA+‐M2BP level, FIB‐4, and APRI had a similar high accuracy of approximately 73% for liver cirrhosis diagnosis. Their levels were significantly correlated with the liver fibrosis stage (p < .0001). WFA+‐M2BP level, FIB‐4, and APRI also had high diagnostic accuracy for varices formation (accuracy, 76.8%–80.2%) and high predictive accuracy for variceal bleeding (accuracy, 73.9%–76.3%). The correlation between WFA+‐M2BP level and FIB‐4 or between WFA+‐M2BP level and APRI was weak (Pearson r < 0.5, p < .0001) but that between FIB‐4 and APRI was very strong (Pearson r > 0.9, p < .0001). Our study demonstrated WFA+‐M2BP level, FIB‐4, and APRI have all shown to be very useful noninvasive methods for evaluating liver fibrosis and predicting esophageal varices bleeding to avoid risky liver biopsy and EGD examination.","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141381970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of gut microbiota and PNPLA3 polymorphisms on nonalcoholic fatty liver disease in lean and obese individuals","authors":"Yen-Po Lin, Yu‐Chieh Tsai, Mu-Jung Tsai, Pao-Yuan Huang, Chien‐Hung Chen, Chih-Chien Yao, S. Chuah, Yuan‐Hung Kuo, W. Tai, Wei‐Shiung Lian, Hsin-Wei Fang, Tsung‐Hui Hu, Ming‐Chao Tsai","doi":"10.1002/aid2.13367","DOIUrl":"https://doi.org/10.1002/aid2.13367","url":null,"abstract":"Nonalcoholic fatty liver disease (NAFLD) is commonly associated with obesity but is also found in non‐obese individuals. The PNPLA3 gene variant (rs738409) is by far the most important genetic determinant of NAFLD. To date, there is no study exploring the differences and associations between gut microbiota and PNPLA3 genotype on lean and obese NAFLD patients. Thus, the aim of this study was to evaluate the association between gut microbiota and lean and obese NAFLD, while considering the role of PNPLA3 variants. This prospective study took place at Kaohsiung Chang Gung Memorial Hospital from December 2019 to November 2020. We recruited 35 lean NAFLD patients, 70 obese NAFLD patients, and 35 healthy individuals. Fecal samples were collected to analyze the V4 region of the 16S rRNA gene for intestinal bacteria composition. Although lean and obese NAFLD groups did not differ in PNPLA3 variant abundance, the lean NAFLD group had a higher percentage of the G allele variant (82.9% vs. 72.9%) than obese NAFLD group. Alpha diversity for gut microbiota was not significantly different among the three groups. Microbiota differed significantly between lean and obese NAFLD groups in a multi‐response permutation procedure analysis (p = .005). Although, there were no significant differences between PNPLA3 G and C in alpha and beta diversity, the same phylum, family, and genus dominant microbiota differed between lean and obese NAFLD. Lean and obese NAFLD patients have different predominant gut microbiota, as do PNPLA3 C and G variants, indicating that lean NAFLD patients may be associated with PNPLA3 G allele variant.","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141383717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic black spots and patches in a 50‐year‐old woman","authors":"P. Le, Tse‐Ching Chen, Cheng‐Tang Chiu","doi":"10.1002/aid2.13405","DOIUrl":"https://doi.org/10.1002/aid2.13405","url":null,"abstract":"","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141383011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incarcerated abdomen wall hernia in an elderly patient","authors":"Li‐Kai Chang, Ming‐Jen Chen, Chia‐Yuan Liu, Chen‐Wang Chang","doi":"10.1002/aid2.13407","DOIUrl":"https://doi.org/10.1002/aid2.13407","url":null,"abstract":"","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141106384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}