BMC Gastroenterology最新文献

{"title":"Relationship between Sarcopenia and minimal hepatic encephalopathy in patients with cirrhosis: a prospective observational study.","authors":"Wasit Wongtrakul, Wimolrak Bandidniyamanon, Phunchai Charatcharoenwitthaya","doi":"10.1186/s12876-025-03674-9","DOIUrl":"10.1186/s12876-025-03674-9","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, characterized by loss of muscle mass and function, has gained importance in the evaluation of cirrhotic patients. Evidence suggests its role in adverse clinical outcomes, including minimal hepatic encephalopathy (MHE). This study aimed to investigate the association between sarcopenia and MHE in patients with cirrhosis.</p><p><strong>Methods: </strong>We prospectively enrolled outpatients with cirrhosis to assess sarcopenia using the 2019 criteria from the Asian Working Group for Sarcopenia. MHE was diagnosed through the Psychometric Hepatic Encephalopathy Score.</p><p><strong>Results: </strong>Of the 210 cirrhotic patients (57.1% male, mean age 62.7 ± 9.6 years), 54 (25.7%) had sarcopenia, with 26 (12.3%) classified as severe. Thirty-seven patients (17.6%) were diagnosed with MHE. Sarcopenia prevalence was significantly higher in patients with MHE compared to those without MHE (45.9% vs. 21.4%). MHE was significantly associated with age, education level, Mini-Mental State Examination score, and a history of hepatic decompensation. No significant associations were found regarding gender, body mass index, comorbidities, sleep quality, and the etiology of cirrhosis. Multivariable logistic regression showed that MHE was significantly associated with age (adjusted odds ratio [aOR] 1.08, 95% CI 1.02-1.13), sarcopenia (aOR 3.29, 95% CI 1.44-7.50), history of overt hepatic encephalopathy (aOR 7.40, 95% CI 1.20-45.56), and variceal bleeding (aOR 3.13, 95% CI 1.38-7.10). Severe sarcopenia was also independently associated with MHE (aOR 3.64, 95% CI 1.32-10.05).</p><p><strong>Conclusions: </strong>Sarcopenia is prevalent in cirrhotic patients and is associated with an increased risk of MHE. Our findings emphasize the importance of assessing sarcopenia to potentially mitigate MHE risk in managing patients with cirrhosis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"88"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the adult and adolescent patient experience with cyclic vomiting syndrome: a concept elicitation study.","authors":"Katja Karrento, Melody Wu, Danielle Rodriguez, Karin S Coyne, Muna J Tahir, Camilla A Richmond, Yaozhu J Chen, James Williams, Thangam Venkatesan","doi":"10.1186/s12876-025-03595-7","DOIUrl":"10.1186/s12876-025-03595-7","url":null,"abstract":"<p><strong>Background: </strong>Cyclic vomiting syndrome (CVS) is a phasic disorder of gut-brain interaction characterized by episodes of severe nausea and vomiting. In-depth qualitative research on phase-specific CVS symptoms and impacts is lacking. The study objectives were to explore the experience of patients with CVS in the United States and to identify CVS symptoms and impacts on adults, adolescents, and caregivers.</p><p><strong>Methods: </strong>Qualitative, cross-sectional, semi-structured concept elicitation interviews were conducted with adults and adolescents with CVS and with adolescents' caregivers. Adolescents either participated alone or in a dyad format with their caregiver. Interview data were analyzed using an open coding approach.</p><p><strong>Results: </strong>Concept elicitation interviews were conducted with 13 adults (mean age 45.3 years [standard deviation (SD) 13.1]) and 15 adolescents (mean age 14.6 years [SD 1.8]). The most frequently reported prodrome phase symptoms were nausea (n = 12, 92.3%), anxiety (n = 10, 76.9%), and abdominal pain (n = 9, 69.2%) in adults, and nausea (n = 15, 100%), abdominal pain (n = 11, 73.3%), and headache (n = 11, 73.3%) in adolescents. All adults reported nausea, tiredness, and dry heaves in the emetic phase, and 12 (92.3%) reported vomiting and retching. The remaining patient said they no longer vomited due to abortive medications. All adolescents reported nausea and vomiting in the emetic phase; other common emetic phase symptoms were abdominal pain (n = 14, 93.3%), dehydration (n = 13, 86.7%), and tiredness (n = 13, 86.7%). The leading most bothersome impact reported by adults was anxiety associated with impending vomiting (n = 5, 38.5%). Among adolescents, the leading most bothersome impact was on school (n = 7/13 asked, 53.8%), and among their caregivers, it was seeing their child suffer (n = 6/11 asked, 54.5%).</p><p><strong>Conclusions: </strong>Patients with CVS experience considerable gastrointestinal and extra-intestinal symptoms. CVS impacts the activities of daily life of patients and their caregivers, with patients reporting negative effects of CVS on their emotional status and their ability to maintain a normal school or work routine.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"85"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and prognostic significance of CD93 in blood vessels in colorectal cancer: an immunohistochemical analysis of 134 cases.","authors":"Shuzhe Yang, Zhongyuan Bai, Fei Zhang, Wei Cui, Peng Bu, Wenqi Bai, Yanfeng Xi","doi":"10.1186/s12876-025-03643-2","DOIUrl":"10.1186/s12876-025-03643-2","url":null,"abstract":"<p><strong>Objective: </strong>Tumor blood vessels are tortuous and dilated, contributing to the aberrant tumor microenvironment. CD93 is a newly reported transmembrane receptor, mainly expressed in tumor endothelial cells, that has demonstrated prognostic value in some cancer types. However, the role of CD93 in the vasculature of colorectal cancer (CRC) tissues and its prognostic significance remain unknown. It is therefore necessary to explore the effect of CD93 in patients with CRC.</p><p><strong>Method: </strong>We detected the expression of CD93 in human CRC tissues using immunohistochemistry. We then examined the correlation between CD93 expression and clinicopathological factors in cancer tissues from 134 patients with CRC.</p><p><strong>Result: </strong>CD93 expression levels were higher in CRC vessels than in vessels in adjacent normal tissues. Upregulation of CD93 was associated with tumor site and microsatellite instability. CD93 protein expression was positively related to macrophage infiltration in CRC. High expression of CD93 may indicate normalization of the tumor vasculature and was associated with better overall survival.</p><p><strong>Conclusion: </strong>CD93 was highly expressed in CRC vessels and correlated with infiltration of immune cells. Our findings reveal that vascular normalization and patient prognosis can be predicted by detecting CD93 expression in CRC tumor tissues.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"84"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand.","authors":"Arunchai Chang, Natthawat Sitthinamsuwan, Nuttanit Pungpipattrakul, Kittiphan Chienwichai, Keerati Akarapatima, Sorawat Sangkaew, Manus Rugivarodom, Attapon Rattanasupar, Bancha Ovartlarnporn, Varayu Prachayakul","doi":"10.1186/s12876-025-03673-w","DOIUrl":"10.1186/s12876-025-03673-w","url":null,"abstract":"<p><strong>Background: </strong>The findings on mortality, rebleeding rate, and hospital stay in patients who underwent early vs. late endoscopy are conflicting. We aimed to compare in-hospital outcomes and medical resource use in patients with acute non-variceal upper gastrointestinal bleeding.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients with acute non-variceal upper gastrointestinal bleeding who underwent early or late endoscopy between 2016 and 2019. The primary outcome was in-hospital mortality. The secondary outcomes were the need for packed red blood cells and number of transfusions, the proportion of lesions with high-risk stigmata, endoscopic and additional hemostasis, in-hospital rebleeding, duration of stay, and admission cost. Statistical analysis was performed using Pearson's chi-squared or Fisher's exact test for categorical variables, Student's t-test, and Wilcoxon rank-sum test for continuous variables.</p><p><strong>Results: </strong>Early and late endoscopies were performed on 451 and 279 patients, respectively. After 1:1 propensity score matching, 278 patients from each group were included, and patients' baseline characteristics were similar in the matched groups. Compared with the late group, the early group had a significantly increased rate of endoscopic hemostasis (22.7% vs. 13.7%, P = 0.006) and a low rate of packed red blood cell transfusion (53.6% vs. 61.9%, P = 0.048). Duration of stay and admission costs were significantly higher in the late group than in the early group (all P < 0.05). After adjusting for confounding factors, early endoscopy was positively associated with ulcers with high-risk stigmata (adjusted odds ratio = 1.83, P = 0.023) and endoscopic hemostasis (adjusted odds ratio = 1.97, P = 0.004). It was negatively associated with the need for packed red blood cell transfusion (adjusted odds ratio = 0.62, P = 0.017) and duration of stay (adjusted coefficient=-0.10, P < 0.001) with no impact on in-hospital mortality, rebleeding, or radiological interventions.</p><p><strong>Conclusions: </strong>The timing of endoscopy does not affect in-hospital mortality or rebleeding rate. This study supports using early endoscopy in patients with acute non-variceal upper gastrointestinal bleeding based on the potential benefits and feasibility of medical resource use.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"86"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis: no evidence that low-dose non-steroidal anti-inflammatory drugs (NSAIDs) reduce the risk of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).","authors":"Weizheng Li, Yihan Ma, Li Yang","doi":"10.1186/s12876-025-03690-9","DOIUrl":"10.1186/s12876-025-03690-9","url":null,"abstract":"<p><strong>Background: </strong>Currently, many studies focus on the use of high-dose NSAIDs, showing significant effectiveness in preventing post-ERCP pancreatitis after surgery. However, some studies suggest that low-dose NSAIDs can also have certain effects. Nevertheless, after using propensity score matching to balance potential biases, the results do not seem ideal and fail to demonstrate clear effectiveness.</p><p><strong>Aim: </strong>This study investigates the effectiveness of NSAIDs in preventing post-ERCP pancreatitis through a systematic review and meta-analysis of relevant literature.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Embase, and Web of Science, covering literature up to September 2024. The search utilized keywords such as \"ERCP,\" \"NSAIDs,\" and \"propensity score matching.\" A total of three studies employing propensity score matching were included, encompassing 857 patients-417 receiving NSAIDs before ERCP and 440 in the control group. Statistical analysis was performed using RevMan 5.3, applying a random-effects model for meta-analysis.</p><p><strong>Results: </strong>The meta-analysis revealed no significant difference in treatment outcomes between the NSAID and control groups, with an odds ratio (OR) of 0.82 (95% CI: 0.45-1.49, P = 0.74) and no observed heterogeneity (I²=0%). Sensitivity analysis confirmed the stability of results, indicating minimal impact from the removal of any single study.</p><p><strong>Discussion: </strong>These findings challenge previous assertions that NSAIDs effectively reduce post-ERCP pancreatitis incidence. The lack of consistent evidence raises concerns about the reliability of existing research. Additionally, the lower NSAID doses used in studies may contribute to the observed ineffectiveness. Future large-scale, well-designed clinical trials are essential to establish clear treatment guidelines and enhance patient outcomes.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"83"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing liver fibrosis detection: a novel PIGR-utilizing approach in chronic hepatitis B injury assessment.","authors":"Shanshan Chu, Yingjun Chen, Yemin Wang","doi":"10.1186/s12876-025-03672-x","DOIUrl":"10.1186/s12876-025-03672-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic Hepatitis B (CHB) is a leading cause of liver fibrosis and cirrhosis worldwide. The early detection of liver fibrosis remains challenging due to the lack of specific symptoms and noninvasive biomarkers with high sensitivity. The polymeric immunoglobulin receptor (PIGR) has recently emerged as a potential biomarker for liver fibrosis. This study aims to evaluate the utility of PIGR in CHB patients as a biomarker for liver fibrosis.</p><p><strong>Methods: </strong>This retrospective study analyzed 150 CHB patients from 2018 to 2023. Based on liver biopsy results, 34 patients were classified as having liver fibrosis, while 116 were categorized as non-fibrosis. Clinical data were compared to assess the relationship between PIGR expression levels and serum fibrosis indices. Logistic regression was performed to identify factors influencing liver fibrosis, and the predictive value of PIGR was evaluated using a receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Significant differences were observed in collagen type IV (CIV), procollagen type III N-terminal peptide (PCIIINP), and hyaluronic acid (HA) levels between the fibrosis and non-fibrosis groups (P < 0.05). PIGR levels were significantly higher in the fibrosis group (P < 0.05) and positively correlated with HA, laminin (LN), PCIII, and CIV levels (P < 0.05). Logistic regression identified HA, LN, PCIIINP, and CIV as risk factors, with PIGR being an independent predictor (P < 0.05). At a cutoff value of 0.35, PIGR showed an area under the curve (AUC) of 0.839, with 81.90% sensitivity, 79.41% specificity, and a Youden's index of 0.613. PIGR also provided a higher net benefit than APRI.</p><p><strong>Conclusion: </strong>PIGR levels are significantly elevated in CHB-related liver fibrosis and correlate closely with established fibrosis markers. As an independent predictor, PIGR demonstrates high diagnostic accuracy and holds promise as a non-invasive biomarker for detecting liver fibrosis in CHB patients, with significant potential for clinical application.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"82"},"PeriodicalIF":2.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic and pathological characteristics of gastrointestinal amyloidosis: a retrospective analysis.","authors":"Zhanyue Niu, Yanfei Lang, Yuting Shen, Hejun Zhang, Yan Xue, Shigang Ding","doi":"10.1186/s12876-025-03670-z","DOIUrl":"10.1186/s12876-025-03670-z","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal amyloidosis (GIA) is a rare manifestation of amyloidosis, characterized by amyloid fibril deposition in the gastrointestinal tract, leading to a range of clinical symptoms. Early diagnosis is challenging due to the nonspecific nature of endoscopic and clinical findings.</p><p><strong>Objective: </strong>To analyze the clinical, endoscopic, and pathological characteristics of GIA and identify potential diagnostic markers for earlier detection.</p><p><strong>Methods: </strong>A retrospective study was conducted on 36 patients diagnosed with GIA based on histopathological findings, including Congo Red staining. Clinical, endoscopic, and pathological data were analyzed to identify correlations between lesion morphology, clinical symptoms, and amyloid deposition.</p><p><strong>Results: </strong>The cohort consisted of 22 males (61.1%) and 14 females (38.9%), with a mean age of 61.7 years. Endoscopic findings were diverse, with elevated lesions (57.1%) most common in the esophagus, stomach, and small intestine, and white patches (66.7%) prevalent in the duodenum. Histopathological analysis confirmed amyloid deposits in 62.8% of biopsy specimens. The small intestine exhibited the highest detection rate (100%), while the colorectum had the lowest (37.5%). Patients with elevated lesions may be asymptomatic, and among those with symptoms, abdominal pain is most common. Flat lesions are primarily associated with multiple symptoms, with abdominal discomfort, pain, distension, and acid reflux being the most frequent. The infiltration depth varied across different gastrointestinal tract segments, with the mucosal layer predominantly affected in the esophagus and stomach, whereas the submucosal layer more significantly involved in the duodenum and colon.</p><p><strong>Conclusion: </strong>Gastrointestinal amyloidosis presents with a wide range of clinical symptoms and endoscopic manifestations. Histopathological diagnosis through standardized biopsy is crucial, and attention should be given to the depth of tissue sampling, as it may play a significant role in reducing misdiagnosis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"81"},"PeriodicalIF":2.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in pediatric patients with intestinal failure without neurodevelopmental delay: a systematic review and meta-analysis.","authors":"Francesco Milo, Deny Menghini, Teresa Capriati, Lorenzo Norsa, Francesco Proli, Giovanni Boroni, Maria Immacolata Spagnuolo, Giovanna Verlato, Antonella Lezo, Claudio Romano, Stefano Vicari, Antonella Diamanti","doi":"10.1186/s12876-025-03682-9","DOIUrl":"10.1186/s12876-025-03682-9","url":null,"abstract":"<p><strong>Background: </strong>Intestinal failure (IF) is a broad term encompassing various conditions that hinder the body's ability to absorb nutrients for growth and maintenance. These conditions can significantly affect child's well-being, leading to physical limitations, psychological distress, and social isolation. We aimed to evaluate the available data on health-related quality of life (HRQoL) in pediatric patients with IF and without neurodevelopmental delay.</p><p><strong>Methods: </strong>For this systematic review and meta-analysis, we searched CINAHL, EMBASE, PsycINFO, PubMed, and Web of Science. All observational studies of pediatric patients (< 18 years) with IF which measured HRQOL and with evidence of absence of neurodevelopmental delay were included, without language or date restrictions, up to June 2024. We did separate random-effects meta-analyses for overall HRQOL and subgroup domains. Evidence from observational studies was synthesised as differences between standardised mean differences (SMDs) for all subgroup domains. Heterogeneity was assessed using the I² statistic and the Cochran Q test. The quality of the evidence was assessed with the Newcastle-Ottawa scale. This study is registered on PROSPERO, number CRD42024561812.</p><p><strong>Results: </strong>Of 491 records identified, 14 were eligible and data were available for 12 studies, all of which had a fair/good quality. The included studies involved a pooled sample of 510 participants (mean age = 7.0 ± 3.6 years). The analysis disclosed that compared to healthy children, pediatric patients with IF had lower overall quality of life in both child- and parent-report (Standardized Mean Difference [SMD]= -0.62; 95% CI [-0.80, -0.43]; p < 0.001, and SMD= -0.70; 95% CI [-1.11, -0.28]; p < 0.001, respectively), except for emotional and social domains (SMD[child] = -0.23; 95% CI [ -0.38, -0.08]; p = 0.001 Vs SMD[parent]= -0.23; 95% CI [ -0.60, 0.14]; p = 0.21, and SMD[child] = -0.40; 95% CI [ -0.70, -0.10]; p = 0.007 Vs SMD[parent]= -0.24; 95% CI [ -0.62, 0.14]; p = 0.21, respectively), where parents overestimate emotional and social HRQOL of their children.</p><p><strong>Conclusions: </strong>This study highlights the significant impact of IF on well-being of pediatric patients. Targeted interventions addressing both physical and psychosocial needs are crucial to improve HRQOL in this population.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"80"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal calprotectin from ileostomy output in patients with Crohn's disease.","authors":"Jung-Bin Park, Jeongkuk Seo, Ji Eun Baek, June Hwa Bae, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang","doi":"10.1186/s12876-025-03652-1","DOIUrl":"10.1186/s12876-025-03652-1","url":null,"abstract":"<p><strong>Background: </strong>Fecal calprotectin (FC) is a reliable biomarker widely used for assessing disease activity and postoperative monitoring in patients with Crohn's disease (CD); however, its efficacy in patients with an ileostomy is poorly understood. Our study evaluated whether FC from the ileostomy output can be used to predict postoperative small bowel inflammation in patients with CD.</p><p><strong>Methods: </strong>Data from patients with CD and an ileostomy who had undergone FC measurement between January 1, 2015, and December 30, 2022, were analyzed retrospectively. Patients were enrolled in the study if they had undergone FC tests with concurrent imaging and/or endoscopic studies, facilitating comparison between FC tests and imaging and/or endoscopic examinations. FC measured with the point-of care (POC) test was denoted as FC-POCT, and that measured using the enzyme-linked immunosorbent assay (ELISA) was denoted as FC-ELISA.</p><p><strong>Results: </strong>This study analyzed 101 patients and 224 FC test results. FC concentration differed significantly in patients with signs of small bowel inflammation on imaging and/or ileoscopy compared with those in remission (FC-POCT: median 191.0 µg/g; interquartile range [IQR], 94.6-499.0 µg/g vs. 29.9 µg/g; IQR, 29.9-50.0 µg/g; P < 0.001; FC-ELISA: median 252.5 µg/g; IQR, 118.5-911.0 µg/g vs. 16.8 µg/g, IQR, 8.2-33.0 µg/g; P < 0.001). The optimal cutoff value for FC-POCT and FC-ELISA to distinguish between small bowel inflammation and remission was 63.3 µg/g (area under the curve [AUC], 0.90; 95% confidence interval [CI], 0.88-0.97) and 40.1 µg/g (AUC, 0.89; 95% CI, 0.79-0.99), respectively. We also compared the diagnostic accuracy between the POC and ELISA testing methods and found no statistically significant difference (P = 0.692).</p><p><strong>Conclusions: </strong>FC from the ileostomy output is a valuable biomarker with high sensitivity and specificity for monitoring small bowel inflammation in postoperative patients with CD and an ileostomy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"78"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic semi-blunt dissection technique is safe and effective for treating gastric submucosal tumors from the muscularis propria.","authors":"Liming Zhang, Rui Zhao, Junxuan Zhang","doi":"10.1186/s12876-025-03669-6","DOIUrl":"10.1186/s12876-025-03669-6","url":null,"abstract":"<p><strong>Background: </strong>Needle knives are the most commonly used instrument during endoscopic treatment for gastric submucosal tumors (SMTs). The conventional resection method involves fully extending the needle-shaped knife head, which allows it to more easily penetrate the muscularis propria while stripping the muscle layer of the tumor. We propose a semi-blunt dissection method that can effectively reduce damage to the muscularis propria.</p><p><strong>Methods: </strong>A total of 113 patients who underwent endoscopic resection of gastric SMTs originating from the muscularis propria were retrospectively analyzed. The conventional method consisted of 73 patients; The other group consisted of 40 patients underwent the semi-blunt dissection method.</p><p><strong>Results: </strong>There was no significant difference between the two groups in age, sex, or lesion location. The intraoperative operational variable, the maximum diameter of gastric muscularis propria damage, was significantly greater in conventional method group than the other group (1.06 ± 0.48 cm vs. 0.46 ± 0.09 cm, p < 0.001). There was also no significant difference between the two groups in terms of histological diagnosis, postoperative complications and the percentage of histologically positive resection margins.</p><p><strong>Conclusion: </strong>The semi-blunt dissection method has certain advantages in the endoscopic resection of gastric tumors originating from the muscularis propria, including a small extent of gastric muscularis propria damage and a shorter postoperative hospital stay.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"77"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}