Minerva gastroenterology最新文献

Gastric juice analysis in clinical practice: are we ready for the prime time?

IF 1.9

Minerva gastroenterology Pub Date : 2025-03-31 DOI: 10.23736/S2724-5985.25.03861-6

Emanuele Dilaghi, Gianluca Esposito, Gianluca Franchellucci, Bruno Annibale, Angelo Zullo

引用次数: 0

Disease-specific non-invasive assessment of liver fibrosis and portal hypertension in 2024.

IF 1.9

Minerva gastroenterology Pub Date : 2025-03-31 DOI: 10.23736/S2724-5985.25.03845-8

Tancredi V Li Cavoli, Armando Curto, Erica N Lynch, Andrea Galli, Stefano Milani

{"title":"Disease-specific non-invasive assessment of liver fibrosis and portal hypertension in 2024.","authors":"Tancredi V Li Cavoli, Armando Curto, Erica N Lynch, Andrea Galli, Stefano Milani","doi":"10.23736/S2724-5985.25.03845-8","DOIUrl":"https://doi.org/10.23736/S2724-5985.25.03845-8","url":null,"abstract":"Advanced liver disease is a global health challenge which requires a timely and accurate diagnosis for optimal patient management. Traditionally, liver biopsy has been the gold standard for diagnosing and staging liver diseases; however, its invasiveness and associated risks, including bleeding, infection, and sampling errors, limit its utility. Non-invasive tests (NITs) have emerged as critical tools in liver disease evaluation, offering safe and effective alternatives to biopsy. This review explores the spectrum of NITs, highlighting their benefits, limitations, and clinical applications in specific liver diseases. NITs have demonstrated significant utility in monitoring chronic viral hepatitis, metabolic-associated steatotic liver disease (MASLD), and cholestatic liver diseases, reducing the need for invasive procedures. While further refinement and validation are needed, NITs represent a major advancement in liver disease management, enhancing early diagnosis, monitoring treatment response, and improving patient outcomes. This review delves into the various non-invasive tests employed in liver disease evaluation, emphasizing their benefits, limitations, and clinical applications. By examining the current landscape of NITs, we aim to elucidate how these advancements are revolutionizing the diagnosis and management of liver diseases, ultimately enhancing patient care and outcomes.","PeriodicalId":94142,"journal":{"name":"Minerva gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756873","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}

引用次数: 0

Endoscopic approaches to small bowel strictures.

IF 1.9

Minerva gastroenterology Pub Date : 2025-03-21 DOI: 10.23736/S2724-5985.25.03868-9

Katelin Durham, Rami El Abiad, Mouen Khashab

引用次数: 0

Clinical aspects and controversies of spontaneous portosystemic shunts in cirrhotic patients.

IF 1.9

Minerva gastroenterology Pub Date : 2025-03-19 DOI: 10.23736/S2724-5985.25.03874-4

Simona Parisse, Erika Coltorti, Flaminia Ferri, Fabio Melandro, Mario Corona, Pierleone Lucatelli, Quirino Lai, Stefano Ginanni Corradini

{"title":"Clinical aspects and controversies of spontaneous portosystemic shunts in cirrhotic patients.","authors":"Simona Parisse, Erika Coltorti, Flaminia Ferri, Fabio Melandro, Mario Corona, Pierleone Lucatelli, Quirino Lai, Stefano Ginanni Corradini","doi":"10.23736/S2724-5985.25.03874-4","DOIUrl":"https://doi.org/10.23736/S2724-5985.25.03874-4","url":null,"abstract":"Spontaneous portosystemic shunts (SPSSs) are common among patients with liver cirrhosis. These vascular structures are collateral veins that directly connect the portal vein system with the systemic circulation. The prevalence increases as cirrhosis worsens. Published studies exist investigating the possible association between presence and extension of SPSSs and clinical manifestation of liver cirrhosis, however some issues continue to be debated. Recent research on this topic has extended knowledge and brought out interesting new aspects. The aim of this review is to provide a comprehensive and updated revision of the role of SPSSs in liver cirrhosis, from pathophysiology to clinical and therapeutic considerations, specifically addressing the most controversial and emerging findings. On this purpose PubMed and Medline were used as data sources and an extensive review of the literature, including the most recent and relevant published studies, was performed. The presence of SPSSs, especially if multiple and/or large, is associated with an increased risk of developing several complications of liver cirrhosis. Patients with higher MELD have larger SPSSs with negative impact on survival. Regarding hepatocellular carcinoma, there is evidence suggesting a potential tumorigenic effect associated with SPSSs, but further investigations on humans are needed. In the context of liver transplantation, the negative effect of SPSSs on graft function and patients' survival is a matter of debate, with no consensus on their surgical management. Currently, several interventional treatments have been proposed for SPSSs that have demonstrated excellent outcomes in selected populations.","PeriodicalId":94142,"journal":{"name":"Minerva gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660174","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}

引用次数: 0

Portal hypertension-associated gastric pathology: role of endoscopic banding ligation.

IF 1.9

Minerva gastroenterology Pub Date : 2025-03-06 DOI: 10.23736/S2724-5985.25.03759-3

Maria L Gambardella, Carmelo Luigiano, Giuseppe LA Torre, Giuseppe G M Scarlata, Francesco Luzza, Ludovico Abenavoli

{"title":"Portal hypertension-associated gastric pathology: role of endoscopic banding ligation.","authors":"Maria L Gambardella, Carmelo Luigiano, Giuseppe LA Torre, Giuseppe G M Scarlata, Francesco Luzza, Ludovico Abenavoli","doi":"10.23736/S2724-5985.25.03759-3","DOIUrl":"https://doi.org/10.23736/S2724-5985.25.03759-3","url":null,"abstract":"Liver cirrhosis, marked by fibrosis and nodular regeneration, triggers a cascade of events resulting in portal hypertension (PH) and, subsequently, hepatic decompensation in its final stages. PH, arising from increased intrahepatic vascular resistance, serves as a harbinger of complications such as ascites, variceal bleeding, and hepatic encephalopathy, underscoring its clinical significance. Timely diagnosis of clinically significant portal hypertension (CSPH) is of pivotal importance, prompting the exploration of noninvasive diagnostic tools such as liver stiffness and spleen stiffness measurement. β-blockers, particularly Carvedilol, emerge as stalwart therapeutic agents in managing CSPH by inducing splanchnic vasoconstriction and reducing cardiac output. However, choosing between β-blockers and endoscopic banding ligation (EBL) for variceal bleeding prophylaxis requires careful consideration, especially in decompensated cirrhosis cases. EBL, while effective in preventing variceal bleeding, has several drawbacks, ranging from its inability to effectively treat PH to its association with upper digestive tract complications such as portal hypertensive gastropathy (PHG) and portal hypertensive polyps (PHPs). This narrative review aims to underline the appropriate diagnostic and therapeutic strategies for PH and to elucidate the relationship between PH, PHG, PHPs, and the use of EBL. This investigation emphasizes the urgency for further research aimed at devising optimal management strategies for PHG and PHPs, particularly in decompensated cirrhosis. Indeed, PH in cirrhotic patients requires a multifaceted approach encompassing early diagnosis, tailored therapeutic interventions, and ongoing research efforts aimed at refining treatment strategies and improving patient outcomes.","PeriodicalId":94142,"journal":{"name":"Minerva gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569261","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}

引用次数: 0

Advanced approaches in the comprehensive management of gastroparesis: from etiology to emerging therapies.

IF 1.9

Minerva gastroenterology Pub Date : 2025-02-27 DOI: 10.23736/S2724-5985.24.03804-X

Vishali Moond, Sahib Singh, Umar Hayat, Parth Patel, Archit Garg, Hassam Ali, Douglas G Adler

引用次数: 0

Barrier and protective effects of a newly developed medical device for the treatment of gastroesophageal reflux disease.

IF 1.9

Minerva gastroenterology Pub Date : 2025-02-27 DOI: 10.23736/S2724-5985.25.03755-6

Federico Benetti, Elisa Gaio, Stefano Agostini

{"title":"Barrier and protective effects of a newly developed medical device for the treatment of gastroesophageal reflux disease.","authors":"Federico Benetti, Elisa Gaio, Stefano Agostini","doi":"10.23736/S2724-5985.25.03755-6","DOIUrl":"https://doi.org/10.23736/S2724-5985.25.03755-6","url":null,"abstract":"Background: Gastroesophageal reflux disease is a clinical condition due to the reflux of stomach contents and leading either to erosive or non-erosive disease. Repeated exposure of esophagus to hydrochloric acid, pepsin, bile salts and pancreatic enzymes in gastric contents damages esophageal mucosa, causing inflammation and increased paracellular permeability. A possible therapy for gastroesophageal reflux disease should hinder gastroesophageal reflux and provide esophageal mucosal protection against all aggressive components. The medical device (Med) tested in this study was developed for the treatment of gastroesophageal reflux disease with the aim to achieve a barrier to protect esophageal mucosa against reflux damages and neutralization of the acidic pocket in the stomach.Methods: The efficacy of Med in forming a protective barrier was performed in vitro using a cellular model of reconstructed human oral epithelium, monitoring its ability to reduce the passage of substances once the formulation was applied, as well as the subsequent reduction in inflammation and toxic effects after exposure to the Triton X-100 stimulus.Results: The medical device is able of creating an effective barrier at the level of epithelial cells. Its protective action is demonstrated by the ability in reducing toxicity and inflammation induced by an irritant agent.Conclusions: This work shows the promising effects of Med as a therapeutic solution for managing signs and symptoms associated with gastroesophageal reflux, capable of exerting its function through a physical action without compromising the physiological balance of epithelial cells.","PeriodicalId":94142,"journal":{"name":"Minerva gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517777","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}

引用次数: 0

Prophylaxis of HBV reinfection and disease in liver transplanted patients: 2024 update on the role of HBIG and cost-effectiveness evaluation.

IF 1.9

Minerva gastroenterology Pub Date : 2025-01-30 DOI: 10.23736/S2724-5985.24.03864-6

Stefano Fagiuoli, Alfredo Marzano, Luciano DE Carlis, Paolo DE Simone, Maria Rendina

{"title":"Prophylaxis of HBV reinfection and disease in liver transplanted patients: 2024 update on the role of HBIG and cost-effectiveness evaluation.","authors":"Stefano Fagiuoli, Alfredo Marzano, Luciano DE Carlis, Paolo DE Simone, Maria Rendina","doi":"10.23736/S2724-5985.24.03864-6","DOIUrl":"https://doi.org/10.23736/S2724-5985.24.03864-6","url":null,"abstract":"Hepatitis B virus (HBV) infection is a major global health concern, with liver transplantation (LT) serving as a critical treatment for end-stage liver disease caused by HBV. However, the risk of HBV reinfection after LT remains significant, necessitating effective prophylaxis. Today, the combination of hepatitis B immune globulin (HBIG) and high-barrier nucleos(t)ide analogues (NUCs) is the standard of care for preventing HBV recurrence post-LT but concerns about the cost of HBIG and access to high-barrier NUCs have led to a reduction in the use, dose, and duration of HBIG in recent years. This review provides an updated analysis of the role of HBIG in preventing HBV recurrence post-LT, alongside a detailed evaluation of its cost-effectiveness, leveraging recent pharmacoeconomic data from Italy. The cost analysis showed that HBIG contributes approximately 12.4% (€ 49,000) to the total lifetime cost of LT-related healthcare (€395,986). Short-term HBIG prophylaxis reduced costs by 11.1%, while lifetime usage increased total costs by only 6.6%. However, the primary cost drivers were renal failure and immunosuppressive therapy. In conclusion, despite advancements in NUCs therapy, HBIG remains a cornerstone of HBV prophylaxis post-LT, particularly in high-risk patients, and discontinuation of HBIG in favor of alternative prophylaxis strategies lacks robust supporting evidence. Tailoring prophylaxis to individual patient needs and risk factors allows for personalized treatment while maintaining efficacy.","PeriodicalId":94142,"journal":{"name":"Minerva gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070461","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}

引用次数: 0

Traditional Chinese medicine nursing strategies for regulating gut microbiome in incontinence-associated dermatitis: a prospective study. 中医药护理对尿失禁相关性皮炎患者肠道菌群调节的前瞻性研究。

IF 1.9

Minerva gastroenterology Pub Date : 2025-01-16 DOI: 10.23736/S2724-5985.24.03726-4

Hong Gao, Jiayan Song

引用次数: 0

Small intestinal bacterial overgrowth: from malabsorption to misinterpretation. 小肠细菌过度生长：从吸收不良到误读。

IF 1.9

Minerva gastroenterology Pub Date : 2025-01-13 DOI: 10.23736/S2724-5985.24.03781-1

Eamonn M Quigley

{"title":"Small intestinal bacterial overgrowth: from malabsorption to misinterpretation.","authors":"Eamonn M Quigley","doi":"10.23736/S2724-5985.24.03781-1","DOIUrl":"https://doi.org/10.23736/S2724-5985.24.03781-1","url":null,"abstract":"Small intestinal bacterial overgrowth (SIBO) was originally described as a cause of maldigestion and malabsorption in situations where disruptions of intestinal anatomy or physiology favored the proliferation of bacteria normally confined to the colon. In this context, the pathogenesis of symptoms resulting from SIBO was well described. More recently, the concept of SIBO was extended to explain symptoms such as bloating, altered bowel habit and discomfort among individuals with irritable bowel syndrome and since then a whole host of gastrointestinal and extragastrointestinal disorders have been attributed to SIBO. In these more recent studies, the diagnosis of SIBO has been largely based on breath hydrogen testing; an approach that is subjected to misinterpretation. Here we critically assess the \"modern\" (as against the \"classical\") concept of SIBO and plead for caution in the application of breath tests, and those that employ lactulose as the substrate, in particular, to the diagnosis of this disorder. We look forward to the application of modern molecular microbiological techniques to the assessment of the small intestinal microbiome and metabolome and the delineation of what is truly normal.","PeriodicalId":94142,"journal":{"name":"Minerva gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974114","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}

引用次数: 0