Journal of digestive diseases and hepatology最新文献

{"title":"Research Progress on the Effect of Traditional Chinese Medicine Monomers and Derived Compounds on Liver Cancer Stem Cells","authors":"Zhong Qi, Yunpeng Guan, Changchuan Bai, Ying Zhu","doi":"10.29011/2574-3511.100078","DOIUrl":"https://doi.org/10.29011/2574-3511.100078","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the most common malignant tumor in the world with a high mortality rate. Liver cancer stem cells (LCSCs) are a small part of HCC cells with the abilities of self-renewal, proliferation, differentiation and tumorigenesis, which may be the main reasons for the high drug resistance and recurrence rate of HCC. Therefore, targeting LCSCs has become an effective way to cure HCC. A lot of evidences show that traditional Chinese medicine (TCM) plays an extremely important role in the prevention and treatment of HCC as an alternative or complementary therapy. In recent years, an increasing number of studies have shown that TCM monomer extracts and their derived compounds target LCSCs through a variety of pathways, providing new ideas for the treatment of liver cancer.","PeriodicalId":91736,"journal":{"name":"Journal of digestive diseases and hepatology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77806411","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":"Alagille Syndrome in an Infant: A Rare Case Report","authors":"Rizwanullah, Muhammad Saad, Qazi Tauseef Ahmad, A. Gul, Kashif Ali, Nida Gul","doi":"10.29011/2574-3511.100076","DOIUrl":"https://doi.org/10.29011/2574-3511.100076","url":null,"abstract":"Alagille syndrome is a rare autosomal dominant disorder that affects multiple organs and systems including liver, heart, bones, vascular system, and kidneys and also causes facial abnormalities. Majority of the cases involve mutation in one copy of the JAG1 gene while rarely some patients may have mutations in NOTCH2 gene. There is substantial variation in the extent of symptomatology with which patients may present. However, mostly patients present in infancy with symptoms concerning liver like jaundice, pruritus due to cholestasis, vitamin A, D, E and K deficiencies. Additional symptoms include specific triangular facies, back pain due vertebras involvement and kidney failure. Diagnosis is generally made up on the basis of clinical manifestations, genetic studies and liver biopsy. Additional laboratory tests concerning the affecting organs like liver function tests etc. may further aid up in the diagnosis. There is no specific treatment and may require symptomatic treatment with multiple disciplinary approach. A 7 months old boy is presented as a case of Alagille syndrome with its typical features.","PeriodicalId":91736,"journal":{"name":"Journal of digestive diseases and hepatology","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85400745","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":"Endoscopic Management and Avoiding Early Surgery in a Rare Case of Type I Mirizzi’s Syndrome","authors":"Amin Elfituri, Mohammed El-Dallal, Haitem Muafa, A. Faisal, Bukeirat","doi":"10.29011/2574-3511.100073","DOIUrl":"https://doi.org/10.29011/2574-3511.100073","url":null,"abstract":"Mirizzi’s syndrome is a rare presentation of gallstones and obstructive jaundice. It occurs when one large stone or multiple small stones get impacted in the Hartman’s pouch or at the cystic duct causing obstruction of the common hepatic duct by external compression. The patient may present with jaundice, fever, right upper quadrant pain. Septic shock can occur Although it’s a rare complication. Early diagnosis with clinical suspicion will prevent further operative management. Also it prevents biliary ductal injuries. We present a case that was successfully treated with endoscopic management [1-5].","PeriodicalId":91736,"journal":{"name":"Journal of digestive diseases and hepatology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87153098","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":"Budget Impact Analysis of HCV Patients’ Pathway: Past, Present and Future in the Italian Landscape","authors":"E. Foglia, E. Garagiola, L. Ferrario, Andrea, Lombardi, C. Grecchi, R. Bruno, B. Menzaghi, G. Rizzardini, D. Croce","doi":"10.29011/2574-3511.100072","DOIUrl":"https://doi.org/10.29011/2574-3511.100072","url":null,"abstract":"Objectives: The present study aims at analysing the budget impact related to the management of patients with Hepatitis C Virus (HCV) in Italy, over the years. Indeed, despite an increasing expenditure related to the novel HCV treatments was registered, due also to an increased therapeutic strategies efficacy, little is known about the expenditure related to the overall pathway, considering the capability of the novel therapies to improve the clinical management of HCV patients. Methods: Economic evaluation considered the biennial cost of 578 HCV patients’ pathway, registered by three Hospitals in Lombardy Region (Italy), and considered the following items of healthcare expenditure: examinations, diagnostic procedures, outpatients and inpatients activities, and day-hospital events, also for the management of drug-related adverse events and complications. HCV population was stratified according to the two different waves of antiviral drugs available in the Italian market (before and after 2017, the year of the introduction and extension of new HCV treatment criteria in the Italian NHS), distinguishing also Sofosbuvir (SOF)based regimes from the others. Three scenarios were simulated and compared, assuming the Italian NHS point of view, and estimating the NHS healthcare expenditure up to three years: 1) Retrospective projection considered the cost of the pathways related to the first wave of drugs and the HCV population effectively treated in the period 2015-2017 (108.887 patients); 2) Hypothetical retrospective projection considered the cost of the pathways related to the second wave of drugs, but the HCV population effectively treated in the period 2015-2017; 3) Perspective projection: considered the cost of the pathways related to the second wave of antiviral drugs, and the forecast HCV population treated in the period 2018-2020 (172.938 patients). Results: In the comparison between the two retrospective projections, NHS total costs devoted to the treatment of HCV patients decreased of -35%: if new treatments had been available since 2015, the economic saving would have been equal to 68,696,848€ (about 630€ per treated patient). Results from perspective projection revealed that the saving were confirmed in the long term (about 500€ per treated patient equal to -28%), despite the increase in the population assuming therapeutic strategies. If the SOFbased regimens market shares increased, savings up to 13% would be registered. Conclusions: The results reported new evidence concerning the resources absorption related to HCV patients. Innovative drugs have increased the expenditure for drugs but ensuring an efficient management of the overall pathway (reduction of 63% in expenditure for hospitalizations), with a lower resource absorption per patient. Journal of Digestive Diseases and Hepatology Foglia E, et al. J Dig Dis Hepatol 6: 172. www.doi.org/10.29011/2574-3511.100072 www.gavinpublishers.com Citation: Foglia E, Garagiola E, Ferrario L, Lombardi","PeriodicalId":91736,"journal":{"name":"Journal of digestive diseases and hepatology","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83870238","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":"Laboratory based Non-Invasive Markers are Suboptimal in Detecting Advanced Fibrosis in Patients with Non-Alcoholic Steatohepatitis","authors":"Na Li, Alexander Miller, A. Hinton, Wei Chen, K. Mumtaz","doi":"10.29011/2574-3511.100171","DOIUrl":"https://doi.org/10.29011/2574-3511.100171","url":null,"abstract":"Background and Aim: Hepatic fibrosis is a major determinant of clinical outcomes in patients with non-alcoholic steatohepatitis (NASH). We aimed to investigate the diagnostic performance of non-invasive tests in detecting advanced fibrosis (F3-4) in a large NASH cohort from central Ohio, the United States. Methods: Data of all patients with biopsy-proven NASH between 2014 and 2017 were collected. Diagnostic performance of aspartate aminotransferase (AST) to platelets ratio index (APRI), fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) were studied. Results: A total of 284 NASH patients were included, 27.82% of whom had F3-4. The cohort was predominantly female (60.92%) and White (88.38%) with a mean age of 50±13 years. The most common comorbidities were obesity (77.11%) and type 2 diabetes (49.65%). There was a significant difference in NFS between fibrosis stage F0-2 and F3-4 (-0.43±1.99 and 0.30±2.28, p=0.01). The sensitivity of APRI <1, FIB-4 <1.3, NFS <-1.455 were 28%, 64%, and 73.33%, respectively. The specificity of APRI ≥2, FIB-4 ≥3.25, NFS ≥0.675 were 93.1%, 84.73%, 74.26%, respectively. The negative predictive value of all three models ranged between 72.59% and 77.72%, and the positive predictive values were consistently low (<40.38%). The area under receiver operator curves of APRI, FIB-4, and NFS were 0.52, 0.55, and 0.59, respectively. Diagnostic performance of these models appeared to be better in older (>35 year) and male population. Conclusion: Overall APRI, FIB-4, NFS were suboptimal in detecting advanced fibrosis in our NASH cohort. Newer non-invasive tests with robust diagnostic accuracy are needed.","PeriodicalId":91736,"journal":{"name":"Journal of digestive diseases and hepatology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73522818","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}