With the obesity epidemic, nonalcoholic fatty liver disease (NAFLD) has become a public health concern, but its progression mechanism remains unclear. Experimental models mimicking human NAFLD/steatohepatitis (NASH) are crucial. This study simulates gut microbiota imbalance effects on NASH and liver fibrosis.
Methods
We used different bacterial sources of lipopolysaccharide (LPS), including Escherichia coli (GEC) and Salmonella abortus equi (GSE), combined with a Gubra Amylin NASH (GAN) diet to induce NASH and liver fibrosis.
Results
The GSE group showed significantly higher serum alanine aminotransferase, hydroxyproline, CD68-positive cells, α-smooth muscle actin, glial fibrillary acidic protein, and TNF-α, COL1A1, TGF-β, and NLRP3 expressions compared to the the GAN group. The GSE group also had higher Erysipelotrichaceae, Akkermansiaceae, and Bacteroidaceae family numbers.
Conclusions
The GAN diet with LPS treatment successfully induced NASH and fibrosis making this model useful for preclinical NASH drug testing.
{"title":"Co-exposure to different bacterial species’ lipopolysaccharides with the NASH diet exacerbates NASH and liver fibrosis progression in mice","authors":"Yen-Peng Lee , Chien-Chao Chiu , Yung-Chi Chang , Yi-Hsun Chen , Wei-Kai Wu , Ming-Shiang Wu , Hsiao-Li Chuang","doi":"10.1016/j.clinre.2024.102470","DOIUrl":"10.1016/j.clinre.2024.102470","url":null,"abstract":"<div><h3>Background and aim</h3><div>With the obesity epidemic, nonalcoholic fatty liver disease (NAFLD) has become a public health concern, but its progression mechanism remains unclear. Experimental models mimicking human NAFLD/steatohepatitis (NASH) are crucial. This study simulates gut microbiota imbalance effects on NASH and liver fibrosis.</div></div><div><h3>Methods</h3><div>We used different bacterial sources of lipopolysaccharide (LPS), including <em>Escherichia coli</em> (GEC) and <em>Salmonella abortus equi</em> (GSE), combined with a Gubra Amylin NASH (GAN) diet to induce NASH and liver fibrosis.</div></div><div><h3>Results</h3><div>The GSE group showed significantly higher serum alanine aminotransferase, hydroxyproline, CD68-positive cells, α-smooth muscle actin, glial fibrillary acidic protein, and <em>TNF-α, COL1A1, TGF-β</em>, and <em>NLRP3</em> expressions compared to the the GAN group. The GSE group also had higher <em>Erysipelotrichaceae, Akkermansiaceae</em>, and <em>Bacteroidaceae</em> family numbers.</div></div><div><h3>Conclusions</h3><div>The GAN diet with LPS treatment successfully induced NASH and fibrosis making this model useful for preclinical NASH drug testing.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102470"},"PeriodicalIF":2.6,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342884","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}
Pub Date : 2024-09-21DOI: 10.1016/j.clinre.2024.102467
Jie Shi , Shan Ji , Mengyao Xu , Yongan Wang , Hui Shi
Background and aim
Selenium, an essential micronutrient for human and has been reported to have a protective effect in ulcerative colitis (UC). However, the role of selenium in UC is unclear. Our aim was to investigate the mechanism of action of selenium in UC.
Methods
Serum selenium levels were measured in UC patients and healthy controls. In addition, the effect of sodium selenite supplementation on experimental colitis in mice treated with dextran sulfate sodium (DSS) was investigated. The effect of sodium selenite on IECs ferroptosis was evaluated by observing the cell mortality, intracellular ferrous content, lipid reactive oxygen species and mitochondrial membrane damage in DSS-treated Caco2 cells. In addition, glutathione peroxidase 4 (Gpx4) and nuclear factor erythroid 2-like 2 (Nrf2) were detected in Caco2 cells and mouse intestines to explore their mechanisms.
Results
The serum selenium content of UC patients was lower than that of healthy subjects. In addition, serum selenium levels were negatively correlated with disease activity. The in vivo results showed that selenium treatment could improve colitis induced by DSS and inhibit IECs ferroptosis. The in vitro results further showed that selenium inhibited the ferroptosis of Caco-2 cells induced by DSS. Nrf2/Gpx4 was up-regulated after selenium supplementation in vivo and in vitro.
Conclusions
Serum selenium level is associated with IECs ferroptosis in UC patients. Selenium can relieve DSS-induced colitis and inhibit IECs ferroptosis by up-regulating the expression of Nrf2/Gpx4.
{"title":"Selenium inhibits ferroptosis in ulcerative colitis through the induction of Nrf2/Gpx4","authors":"Jie Shi , Shan Ji , Mengyao Xu , Yongan Wang , Hui Shi","doi":"10.1016/j.clinre.2024.102467","DOIUrl":"10.1016/j.clinre.2024.102467","url":null,"abstract":"<div><h3>Background and aim</h3><div>Selenium, an essential micronutrient for human and has been reported to have a protective effect in ulcerative colitis (UC). However, the role of selenium in UC is unclear. Our aim was to investigate the mechanism of action of selenium in UC.</div></div><div><h3>Methods</h3><div>Serum selenium levels were measured in UC patients and healthy controls. In addition, the effect of sodium selenite supplementation on experimental colitis in mice treated with dextran sulfate sodium (DSS) was investigated. The effect of sodium selenite on IECs ferroptosis was evaluated by observing the cell mortality, intracellular ferrous content, lipid reactive oxygen species and mitochondrial membrane damage in DSS-treated Caco2 cells. In addition, glutathione peroxidase 4 (Gpx4) and nuclear factor erythroid 2-like 2 (Nrf2) were detected in Caco2 cells and mouse intestines to explore their mechanisms.</div></div><div><h3>Results</h3><div>The serum selenium content of UC patients was lower than that of healthy subjects. In addition, serum selenium levels were negatively correlated with disease activity. The in vivo results showed that selenium treatment could improve colitis induced by DSS and inhibit IECs ferroptosis. The in vitro results further showed that selenium inhibited the ferroptosis of Caco-2 cells induced by DSS. Nrf2/Gpx4 was up-regulated after selenium supplementation in vivo and in vitro.</div></div><div><h3>Conclusions</h3><div>Serum selenium level is associated with IECs ferroptosis in UC patients. Selenium can relieve DSS-induced colitis and inhibit IECs ferroptosis by up-regulating the expression of Nrf2/Gpx4.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102467"},"PeriodicalIF":2.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307258","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}
Pub Date : 2024-09-21DOI: 10.1016/j.clinre.2024.102468
Fu Xiao, Yusong Wei, Peng Zou, Xiaobin Wu
Objective
The etiology of ulcerative colitis (UC) is complex and involves multiple factors, with exposure to environmental toxins potentially contributing greatly to its pathogenesis. Therefore, this study was carried out with the purpose of delving into the associations between single and combined exposures to environmental phenols and UC among American adults.
Methods
Survey data from the 2009–2010 National Health and Nutrition Examination Survey were selected for our research. The associations between single and combined exposures to environmental phenols and the prevalence of UC were analyzed using weighted multivariate logistic regression models as well as Bayesian kernel machine regression (BKMR).
Results
A total of 1,422 adults aged 20 years old and above were included in this study, 17 of whom had UC. The correlation matrix showed strong associations between 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) (R = 0.81), as well as between 2,4,5-trichlorophenol (2,4,5-TCP) and 2,4,6-trichlorophenol (2,4,6-TCP) (R = 0.73). The logistic regression model revealed that, after adjusting for confounders, exposure to environmental phenols was positively associated with the prevalence of UC, with 2,4,6-TCP showing a significant association (OR = 2.37, 95 % CI = 1.10, 5.09, P = 0.037). The BKMR analysis indicated an upward trend in the overall effect of combined exposures to environmental phenols on UC. All five phenols contributed to this effect, with 2,4,6-TCP exhibiting the most pronounced effect. When other compounds were fixed at the 50th percentile, the impact of the five phenols on UC demonstrated a positive association, without any noteworthy interaction among the compounds.
Conclusion
Our findings suggested that exposure to environmental phenols may contribute to the occurrence of UC among American adults.
{"title":"Associations between single and combined exposures to environmental phenols and ulcerative colitis in American adults","authors":"Fu Xiao, Yusong Wei, Peng Zou, Xiaobin Wu","doi":"10.1016/j.clinre.2024.102468","DOIUrl":"10.1016/j.clinre.2024.102468","url":null,"abstract":"<div><h3>Objective</h3><div>The etiology of ulcerative colitis (UC) is complex and involves multiple factors, with exposure to environmental toxins potentially contributing greatly to its pathogenesis. Therefore, this study was carried out with the purpose of delving into the associations between single and combined exposures to environmental phenols and UC among American adults.</div></div><div><h3>Methods</h3><div>Survey data from the 2009–2010 National Health and Nutrition Examination Survey were selected for our research. The associations between single and combined exposures to environmental phenols and the prevalence of UC were analyzed using weighted multivariate logistic regression models as well as Bayesian kernel machine regression (BKMR).</div></div><div><h3>Results</h3><div>A total of 1,422 adults aged 20 years old and above were included in this study, 17 of whom had UC. The correlation matrix showed strong associations between 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) (<em>R</em> = 0.81), as well as between 2,4,5-trichlorophenol (2,4,5-TCP) and 2,4,6-trichlorophenol (2,4,6-TCP) (<em>R</em> = 0.73). The logistic regression model revealed that, after adjusting for confounders, exposure to environmental phenols was positively associated with the prevalence of UC, with 2,4,6-TCP showing a significant association (OR = 2.37, 95 % CI = 1.10, 5.09, <em>P</em> = 0.037). The BKMR analysis indicated an upward trend in the overall effect of combined exposures to environmental phenols on UC. All five phenols contributed to this effect, with 2,4,6-TCP exhibiting the most pronounced effect. When other compounds were fixed at the 50th percentile, the impact of the five phenols on UC demonstrated a positive association, without any noteworthy interaction among the compounds.</div></div><div><h3>Conclusion</h3><div>Our findings suggested that exposure to environmental phenols may contribute to the occurrence of UC among American adults.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102468"},"PeriodicalIF":2.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307257","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}
Pub Date : 2024-09-20DOI: 10.1016/j.clinre.2024.102466
Rui Wu , Sijia Yuan , Yuxuan Wang , Yangli Nan , Zixiao Chen , Hong Yuan , Zixuan Wang , Zuojing Li , Dongsheng Zong
Background
Ramucirumab is considered a potential treatment for gastric or gastroesophageal cancer; however, its safety has not been evaluated. This meta-analysis aimed to evaluate the efficacy and safety of ramucirumab for treating gastric or gastroesophageal cancer.
Methods
The databases of PubMed, Embase, and Cochrane Library were searched through October 2023. The search focused on randomized controlled trials (RCTs) comparing ramucirumab (with or without chemotherapy) to a placebo (with or without chemotherapy) in patients with gastric or gastroesophageal cancer. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were pooled.
Results
Seven RCTs with a total of 2613 patients were included. Compared with placebo (with or without chemotherapy), ramucirumab (with or without chemotherapy) significantly improved OS (HR: 0.90, 95% CI: 0.82–0.99, p = 0.030), PFS (HR: 0.74, 95% CI: 0.60–0.90, p = 0.003), ORR (OR: 1.39, 95% CI: 1.15–1.67, p < 0.001), and DCR (OR: 1.91, 95% CI: 1.38–2.63, p < 0.001). However, ramucirumab (with or without chemotherapy) also increased the incidence of decreased appetite (OR: 1.29, 95% CI: 1.09–1.53, p = 0.004), diarrhea (OR: 1.39, 95% CI: 1.01–1.91, p = 0.05), hypertension (OR: 3.13, 95% CI: 2.03–4.83, p < 0.00001), and bleeding or hemorrhage (OR: 2.34, 95% CI: 1.93–2.85, p < 0.00001).
Conclusions
Ramucirumab (with or without chemotherapy) can improve OS, PFS, ORR and DCR in patients with gastric or gastroesophageal cancer. However, it may also increase the incidence of specific AEs.
{"title":"Efficacy and safety of ramucirumab in gastric or gastroesophageal cancer: A systematic review and meta-analysis","authors":"Rui Wu , Sijia Yuan , Yuxuan Wang , Yangli Nan , Zixiao Chen , Hong Yuan , Zixuan Wang , Zuojing Li , Dongsheng Zong","doi":"10.1016/j.clinre.2024.102466","DOIUrl":"10.1016/j.clinre.2024.102466","url":null,"abstract":"<div><h3>Background</h3><p>Ramucirumab is considered a potential treatment for gastric or gastroesophageal cancer; however, its safety has not been evaluated. This meta-analysis aimed to evaluate the efficacy and safety of ramucirumab for treating gastric or gastroesophageal cancer.</p></div><div><h3>Methods</h3><p>The databases of PubMed, Embase, and Cochrane Library were searched through October 2023. The search focused on randomized controlled trials (RCTs) comparing ramucirumab (with or without chemotherapy) to a placebo (with or without chemotherapy) in patients with gastric or gastroesophageal cancer. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were pooled.</p></div><div><h3>Results</h3><p>Seven RCTs with a total of 2613 patients were included. Compared with placebo (with or without chemotherapy), ramucirumab (with or without chemotherapy) significantly improved OS (HR: 0.90, 95% CI: 0.82–0.99, <em>p</em> = 0.030), PFS (HR: 0.74, 95% CI: 0.60–0.90, <em>p</em> = 0.003), ORR (OR: 1.39, 95% CI: 1.15–1.67, <em>p</em> < 0.001), and DCR (OR: 1.91, 95% CI: 1.38–2.63, <em>p</em> < 0.001). However, ramucirumab (with or without chemotherapy) also increased the incidence of decreased appetite (OR: 1.29, 95% CI: 1.09–1.53, <em>p</em> = 0.004), diarrhea (OR: 1.39, 95% CI: 1.01–1.91, <em>p</em> = 0.05), hypertension (OR: 3.13, 95% CI: 2.03–4.83, <em>p</em> < 0.00001), and bleeding or hemorrhage (OR: 2.34, 95% CI: 1.93–2.85, <em>p</em> < 0.00001).</p></div><div><h3>Conclusions</h3><p>Ramucirumab (with or without chemotherapy) can improve OS, PFS, ORR and DCR in patients with gastric or gastroesophageal cancer. However, it may also increase the incidence of specific AEs.</p></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 8","pages":"Article 102466"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270844","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}
Pub Date : 2024-09-13DOI: 10.1016/j.clinre.2024.102459
Ning-Bo Hao , Ying Zhou , Dan Zhang , Yan-Nan Li , Tian Tian , Yan-Jun Guo , Ying Zhang , Chang-Zheng Li
Several investigators have reported that sarcopenia is common in patients with liver cirrhosis. However, few studies have probed the association between sarcopenia and liver cirrhosis complicated with oesophageal and gastric variceal bleeding (LC-EGVB). We aimed to investigate the impact of sarcopenia on rebleeding after endoscopic therapy in patients with LC-EGVB. Computed tomography (CT) radiographs from the third lumbar vertebra were selected to analyse body composition, including skeletal muscle tissue, visceral and subcutaneous adipose tissue using SliceOmatic software. Sarcopenia was defined using validated cutoff values for patients with liver cirrhosis: 44.77 cm2/m2 for men and 32.50 cm2/m2 for women. A total of 187 patients with LC-EGVB and 309 controls were included in this study. The rate of sarcopenia in controls (17.4 %) was significantly lower than that in patients with LC-EGVB (41.2 %). Patients with LC-EGVB exhibiting sarcopenia showed a high prevalence of portal vein thrombosis and rebleeding rate at 1 year. The rate of sarcopenia in the rebleeding group was significantly higher than that in the non-rebleeding group. Univariate and multivariate analyses showed that sarcopenia was an independent risk factor for rebleeding within 1 year in patients with LC-EGVB. Patients with LC-EGVB displayed a high prevalence of sarcopenia. Sarcopenia was observed to be an independent risk factor for rebleeding within 1 year.
{"title":"Effect of sarcopenia on liver cirrhosis with complicating oesophageal and gastric varices after endoscopic therapy","authors":"Ning-Bo Hao , Ying Zhou , Dan Zhang , Yan-Nan Li , Tian Tian , Yan-Jun Guo , Ying Zhang , Chang-Zheng Li","doi":"10.1016/j.clinre.2024.102459","DOIUrl":"10.1016/j.clinre.2024.102459","url":null,"abstract":"<div><p>Several investigators have reported that sarcopenia is common in patients with liver cirrhosis. However, few studies have probed the association between sarcopenia and liver cirrhosis complicated with oesophageal and gastric variceal bleeding (LC-EGVB). We aimed to investigate the impact of sarcopenia on rebleeding after endoscopic therapy in patients with LC-EGVB. Computed tomography (CT) radiographs from the third lumbar vertebra were selected to analyse body composition, including skeletal muscle tissue, visceral and subcutaneous adipose tissue using SliceOmatic software. Sarcopenia was defined using validated cutoff values for patients with liver cirrhosis: 44.77 cm<sup>2</sup>/m<sup>2</sup> for men and 32.50 cm<sup>2</sup>/m<sup>2</sup> for women. A total of 187 patients with LC-EGVB and 309 controls were included in this study. The rate of sarcopenia in controls (17.4 %) was significantly lower than that in patients with LC-EGVB (41.2 %). Patients with LC-EGVB exhibiting sarcopenia showed a high prevalence of portal vein thrombosis and rebleeding rate at 1 year. The rate of sarcopenia in the rebleeding group was significantly higher than that in the non-rebleeding group. Univariate and multivariate analyses showed that sarcopenia was an independent risk factor for rebleeding within 1 year in patients with LC-EGVB. Patients with LC-EGVB displayed a high prevalence of sarcopenia. Sarcopenia was observed to be an independent risk factor for rebleeding within 1 year.</p></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 8","pages":"Article 102459"},"PeriodicalIF":2.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2210740124001803/pdfft?md5=3243313f0ea47f7a7c47b8ff6a80e2d1&pid=1-s2.0-S2210740124001803-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12DOI: 10.1016/j.clinre.2024.102462
Boxuan Lu , Meiling Zhang , Zhihui Wang , Wenhao Zhang , Yinxiao Lu , Jianfeng Gong , Zhifang Wu , Qing Ji
Background
Surgical site infection (SSI) is a significant concern due to its potential to cause delayed wound healing and prolonged hospital stays. This study aims to develop a predictive model in patients with Crohn's disease.
Methods
We conducted single-factor and multi-factor logistic regression analyses to identify risk factors, resulting in the development of a logistic regression model and the creation of a nomogram. The model's effect was validated by employing enhanced bootstrap resampling techniques, calibration curves, and DCA curves. Finally, we investigated the risk factors for wall and intra-abdominal infections separately.
Results
90 of 675 patients (13.3 %) developed SSI. Several independent risk factors for SSI were identified, including higher postoperative day one neutrophil count (p = 0.033), higher relative blood loss (p = 0.018), female gender (p = 0.021), preoperative corticosteroid use (p = 0.007), Montreal classification A1 and L2 (p < 0.05), previous intestinal resection (p = 0.017), and remaining lesions (p = 0.015). Additionally, undergoing strictureplasty (p = 0.041) is a protective factor against SSI. These nine variables were used to develop an SSI prediction model presented as a nomogram. The model demonstrated strong discrimination (adjusted C-statistic=0.709, 95 % CI: 0.659∼0.757) and precise calibration. The decision curve showed that the nomogram was clinically effective within a probability threshold range of 3 % to 54 %. Further subgroup analysis revealed distinct risk factors for wall infections and intra-abdominal infections.
Conclusion
We established a new predictive model, which can guide the prevention and postoperative care of SSI after Crohn's disease bowel resection surgery to minimize its occurrence rate.
{"title":"Development of a nomogram for postoperative surgical site infections in patients undergoing bowel resection for Crohn's disease","authors":"Boxuan Lu , Meiling Zhang , Zhihui Wang , Wenhao Zhang , Yinxiao Lu , Jianfeng Gong , Zhifang Wu , Qing Ji","doi":"10.1016/j.clinre.2024.102462","DOIUrl":"10.1016/j.clinre.2024.102462","url":null,"abstract":"<div><h3>Background</h3><p>Surgical site infection (SSI) is a significant concern due to its potential to cause delayed wound healing and prolonged hospital stays. This study aims to develop a predictive model in patients with Crohn's disease.</p></div><div><h3>Methods</h3><p>We conducted single-factor and multi-factor logistic regression analyses to identify risk factors, resulting in the development of a logistic regression model and the creation of a nomogram. The model's effect was validated by employing enhanced bootstrap resampling techniques, calibration curves, and DCA curves. Finally, we investigated the risk factors for wall and intra-abdominal infections separately.</p></div><div><h3>Results</h3><p>90 of 675 patients (13.3 %) developed SSI. Several independent risk factors for SSI were identified, including higher postoperative day one neutrophil count (<em>p</em> = 0.033), higher relative blood loss (<em>p</em> = 0.018), female gender (<em>p</em> = 0.021), preoperative corticosteroid use (<em>p</em> = 0.007), Montreal classification A1 and L2 (<em>p</em> < 0.05), previous intestinal resection (<em>p</em> = 0.017), and remaining lesions (<em>p</em> = 0.015). Additionally, undergoing strictureplasty (<em>p</em> = 0.041) is a protective factor against SSI. These nine variables were used to develop an SSI prediction model presented as a nomogram. The model demonstrated strong discrimination (adjusted C-statistic=0.709, 95 % CI: 0.659∼0.757) and precise calibration. The decision curve showed that the nomogram was clinically effective within a probability threshold range of 3 % to 54 %. Further subgroup analysis revealed distinct risk factors for wall infections and intra-abdominal infections.</p></div><div><h3>Conclusion</h3><p>We established a new predictive model, which can guide the prevention and postoperative care of SSI after Crohn's disease bowel resection surgery to minimize its occurrence rate.</p></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 8","pages":"Article 102462"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238616","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}
Pub Date : 2024-09-12DOI: 10.1016/j.clinre.2024.102461
Alexis Couret , James A King , Bruno Pereira , Daniel Courteix , Philippe Obert , Agnes Vinet , Guillaume Walther , Bruno Lesourd , Robert Chapier , Marek Zak , Reza Bagheri , Chris U Ugbolue , Armand Abergel , David Thivel , Frédéric Dutheil , Gaël Ennequin
Introduction
Metabolic associated liver disease (MASLD) is the most common liver disease in the world especially in people with metabolic syndrome. First-line treatments mainly consist in lifestyle modifications for these populations. The main objective of this study is to assess the effect of a short intervention program with different exercise modalities on Fatty Liver Index (FLI) in patients with metabolic syndrome.
Methods
85 patients (40 men, 45 women) with metabolic syndrome and liver steatosis were randomized in 3 groups for a 3 weeks residential program: Re group—high-resistance-moderate-endurance; rE group—moderate-resistance with high-endurance and re group—moderate-resistance with moderate-endurance. Patients also followed a negative energy balance of 500 kcal/day. Then, a follow-up of 1 year with interviews with dieticians and exercise physicians to maintain lifestyle modification was performed. Anthropometric, cardiometabolic and hepatic outcomes were performed at baseline, at the end of the 3-week residential program, 3 months, 6 months and 12 months after baseline.
Results
This study demonstrated that all three training programs significantly improve FLI and that this effect was lasting among the follow-up (p < 0.001). More specifically, the Re group exhibited a more pronounced decrease in FLI compared with re (p < 0.05). Finally, the decrease in FLI was associated with improvement in anthropometric and cardiometabolic outcomes at 3-weeks (p < 0.001) and 3-months (p < 0.01).
Conclusion
Short duration program is effective to improve FLI and cardiometabolic parameters in MASLD patients. Encourage to increase physical activity even for a short duration is relevant in this population.
{"title":"Effect of different modalities of exercise on Fatty Liver Index in patients with metabolic syndrome: The RESOLVE randomized trial","authors":"Alexis Couret , James A King , Bruno Pereira , Daniel Courteix , Philippe Obert , Agnes Vinet , Guillaume Walther , Bruno Lesourd , Robert Chapier , Marek Zak , Reza Bagheri , Chris U Ugbolue , Armand Abergel , David Thivel , Frédéric Dutheil , Gaël Ennequin","doi":"10.1016/j.clinre.2024.102461","DOIUrl":"10.1016/j.clinre.2024.102461","url":null,"abstract":"<div><h3>Introduction</h3><p>Metabolic associated liver disease (MASLD) is the most common liver disease in the world especially in people with metabolic syndrome. First-line treatments mainly consist in lifestyle modifications for these populations. The main objective of this study is to assess the effect of a short intervention program with different exercise modalities on Fatty Liver Index (FLI) in patients with metabolic syndrome.</p></div><div><h3>Methods</h3><p>85 patients (40 men, 45 women) with metabolic syndrome and liver steatosis were randomized in 3 groups for a 3 weeks residential program: <em>Re group</em>—high-resistance-moderate-endurance; <em>rE group</em>—moderate-resistance with high-endurance and <em>re group</em>—moderate-resistance with moderate-endurance. Patients also followed a negative energy balance of 500 kcal/day. Then, a follow-up of 1 year with interviews with dieticians and exercise physicians to maintain lifestyle modification was performed. Anthropometric, cardiometabolic and hepatic outcomes were performed at baseline, at the end of the 3-week residential program, 3 months, 6 months and 12 months after baseline.</p></div><div><h3>Results</h3><p>This study demonstrated that all three training programs significantly improve FLI and that this effect was lasting among the follow-up (<em>p</em> < 0.001). More specifically, the <em>Re</em> group exhibited a more pronounced decrease in FLI compared with re (<em>p</em> < 0.05). Finally, the decrease in FLI was associated with improvement in anthropometric and cardiometabolic outcomes at 3-weeks (<em>p</em> < 0.001) and 3-months (<em>p</em> < 0.01).</p></div><div><h3>Conclusion</h3><p>Short duration program is effective to improve FLI and cardiometabolic parameters in MASLD patients. Encourage to increase physical activity even for a short duration is relevant in this population.</p></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 8","pages":"Article 102461"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232730","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}
Pub Date : 2024-09-12DOI: 10.1016/j.clinre.2024.102463
Chengu Niu , Jing Zhang , Abdullah Orakzai , L K Teja Boppana , Ahmed Elkhapery , Basil Verghese , Patrick I Okolo 3rd
Background
Percutaneous endoscopic gastrostomy (PEG) tubes are commonly inserted to provide a route for enteral feeding in patients who are unlikely to have adequate oral intake for prolonged periods of time. This study aims to determine the incidence of aspiration pneumonia among PEG tube patients.
Methods
We conducted a retrospective analysis of NIS database records (October 2015 to December 2020) for patients with PEG. Primary and secondary outcomes were assessed using ICD-10-CM/PCS codes.
Results
We identified a total of 2,053,560 weighted hospitalizations involving patients with PEG tube. Those with aspiration pneumonia were older (mean age 67.01 vs. 63.85, p < 0.01) and were predominantly male. At baseline, the aspiration pneumonia group had higher rates of dementia (AOR 1.22, 95 % CI: 1.19–1.24), malnutrition (AOR 1.13, 95 % CI: 1.11–1.15), cerebrovascular disease (AOR 1.29, 95 % CI 1.25–1.33), cardiac arrhythmias (AOR 1.05, 95 % CI 1.03–1.08), congestive heart failure (AOR 1.20, 95 % CI 1.17–1.24), COPD (AOR 1.18, 95 % CI 1.15–1.20), paralysis (AOR 1.06, 95 % CI 1.03–1.09), alcohol abuse (AOR 1.12, 95 % CI 1.07–1.17), and psychoses (AOR 1.07, 95 % CI 1.02–1.13). Those with aspiration pneumonia exhibited increased mortality (p < 0.01, AOR 1.59, 95 % CI 1.54–1.65), higher incidence of severe sepsis (AOR 2.03, 95 % CI 1.98–2.07) and longer hospital stays, and accrued greater hospital charges (p < 0.01). Notably, while GERD is typically considered a risk factor for AP, our findings indicated that GERD was associated with a decreased risk of AP in this patient population.
Conclusion
Patients with a PEG tube who develop aspiration pneumonia experience increased mortality rates, extended hospitalizations, a higher frequency of septic shock, and augmented healthcare consumption. Notably, old male, congestive heart failure, cerebrovascular disease, dementia, and COPD play a pivotal role in predicting these outcomes.
{"title":"Predictors and inpatient outcomes of aspiration pneumonia in patients with percutaneous endoscopic gastrostomy tube: An analysis of national inpatient sample","authors":"Chengu Niu , Jing Zhang , Abdullah Orakzai , L K Teja Boppana , Ahmed Elkhapery , Basil Verghese , Patrick I Okolo 3rd","doi":"10.1016/j.clinre.2024.102463","DOIUrl":"10.1016/j.clinre.2024.102463","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous endoscopic gastrostomy (PEG) tubes are commonly inserted to provide a route for enteral feeding in patients who are unlikely to have adequate oral intake for prolonged periods of time. This study aims to determine the incidence of aspiration pneumonia among PEG tube patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of NIS database records (October 2015 to December 2020) for patients with PEG. Primary and secondary outcomes were assessed using ICD-10-CM/PCS codes.</div></div><div><h3>Results</h3><div>We identified a total of 2,053,560 weighted hospitalizations involving patients with PEG tube. Those with aspiration pneumonia were older (mean age 67.01 vs. 63.85, <em>p</em> < 0.01) and were predominantly male. At baseline, the aspiration pneumonia group had higher rates of dementia (AOR 1.22, 95 % CI: 1.19–1.24), malnutrition (AOR 1.13, 95 % CI: 1.11–1.15), cerebrovascular disease (AOR 1.29, 95 % CI 1.25–1.33), cardiac arrhythmias (AOR 1.05, 95 % CI 1.03–1.08), congestive heart failure (AOR 1.20, 95 % CI 1.17–1.24), COPD (AOR 1.18, 95 % CI 1.15–1.20), paralysis (AOR 1.06, 95 % CI 1.03–1.09), alcohol abuse (AOR 1.12, 95 % CI 1.07–1.17), and psychoses (AOR 1.07, 95 % CI 1.02–1.13). Those with aspiration pneumonia exhibited increased mortality (<em>p</em> < 0.01, AOR 1.59, 95 % CI 1.54–1.65), higher incidence of severe sepsis (AOR 2.03, 95 % CI 1.98–2.07) and longer hospital stays, and accrued greater hospital charges (<em>p</em> < 0.01). Notably, while GERD is typically considered a risk factor for AP, our findings indicated that GERD was associated with a decreased risk of AP in this patient population.</div></div><div><h3>Conclusion</h3><div>Patients with a PEG tube who develop aspiration pneumonia experience increased mortality rates, extended hospitalizations, a higher frequency of septic shock, and augmented healthcare consumption. Notably, old male, congestive heart failure, cerebrovascular disease, dementia, and COPD play a pivotal role in predicting these outcomes.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102463"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281410","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}
Pub Date : 2024-09-12DOI: 10.1016/j.clinre.2024.102465
Li Liu, Wenyu He, Jiaoping Liu
Objective
This review assesses the efficacy and safety of the combination of transarterial chemoembolization (TACE) and camrelizumab for treating advanced hepatocellular carcinoma (HCC) and is to provide a goal, evidence-based medical foundation for effectively guiding clinical practice.
Methods
We conducted a computerized search of six electronic databases to identify studies pertinent to the combination of TACE and camrelizumab for treating advanced HCC. For further analysis of clinical indicators and adverse events data, we utilized random or fixed-effect models to account for heterogeneity between studies.
Results
As of May 30, 2023, 12 articles were included for Meta-analysis, encompassing 1123 patients with advanced HCC. The results indicated that the combined objective response rate (ORR) and disease control rate (DCR) were 51.1 % and 86.8 %, respectively. Regarding survival indicators, the combined overall survival (OS) and progression-free survival (PFS) were 24.26 months and 11.84 months, respectively. Among the adverse events observed, the highest incidence rates for TACE combined with camrelizumab were fever (all grade: 46.5 %, ≥grade III: 5.0 %), hypertension (all grade: 32.2 %, ≥grade III: 8.5 %), transaminase elevation (all grade: 34.7 %, ≥grade III: 13.4 %), and nausea and vomiting (all grade: 43.9 %, ≥grade III: 2.5 %).
Conclusions
This study demonstrated the efficacy and safety of combining TACE with camrelizumab in treating patients with advanced HCC, providing valuable evidence for its prospective clinical application. However, due to the limited availability of clinical data, it is essential to design larger-scale and multi-center clinical randomized controlled trials in the future to validate and confirm these findings definitively.
{"title":"Camrelizumab combined with transcatheter arterial chemoembolization for intermediate or advanced hepatocellular carcinoma: A systematic review and meta-analysis","authors":"Li Liu, Wenyu He, Jiaoping Liu","doi":"10.1016/j.clinre.2024.102465","DOIUrl":"10.1016/j.clinre.2024.102465","url":null,"abstract":"<div><h3>Objective</h3><div>This review assesses the efficacy and safety of the combination of transarterial chemoembolization (TACE) and camrelizumab for treating advanced hepatocellular carcinoma (HCC) and is to provide a goal, evidence-based medical foundation for effectively guiding clinical practice.</div></div><div><h3>Methods</h3><div>We conducted a computerized search of six electronic databases to identify studies pertinent to the combination of TACE and camrelizumab for treating advanced HCC. For further analysis of clinical indicators and adverse events data, we utilized random or fixed-effect models to account for heterogeneity between studies.</div></div><div><h3>Results</h3><div>As of May 30, 2023, 12 articles were included for Meta-analysis, encompassing 1123 patients with advanced HCC. The results indicated that the combined objective response rate (ORR) and disease control rate (DCR) were 51.1 % and 86.8 %, respectively. Regarding survival indicators, the combined overall survival (OS) and progression-free survival (PFS) were 24.26 months and 11.84 months, respectively. Among the adverse events observed, the highest incidence rates for TACE combined with camrelizumab were fever (all grade: 46.5 %, ≥grade III: 5.0 %), hypertension (all grade: 32.2 %, ≥grade III: 8.5 %), transaminase elevation (all grade: 34.7 %, ≥grade III: 13.4 %), and nausea and vomiting (all grade: 43.9 %, ≥grade III: 2.5 %).</div></div><div><h3>Conclusions</h3><div>This study demonstrated the efficacy and safety of combining TACE with camrelizumab in treating patients with advanced HCC, providing valuable evidence for its prospective clinical application. However, due to the limited availability of clinical data, it is essential to design larger-scale and multi-center clinical randomized controlled trials in the future to validate and confirm these findings definitively.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102465"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281411","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}
Pub Date : 2024-09-12DOI: 10.1016/j.clinre.2024.102464
Ke-min Jin , Quan Bao , Ting-ting Zhao , Hong-wei Wang , Long-fei Huang , Kun Wang , Bao-cai Xing
Introduction
The prognostic value of baseline variant allele frequency (VAF) in circulating tumor DNA (ctDNA) of colorectal cancer liver metastases (CRLM) patients after curative resection was rarely investigated.
Methods
A single-center prospective study was performed to investigate the prognostic impact of baseline VAF in ctDNA and matched tumor tissues of CRLM patients after curative resection between May 2019 and May 2021 by the Illumina NovoSeq 6000 platform. The relationship of the tumor burden score (TBS) and the VAF in ctDNA and matched tumor tissues was evaluated by the Pearson correlation method. The survival curves of recurrence-free survival (RFS) and overall survival (OS) were plotted. Factors associated with RFS were calculated using Cox regression analysis, and an integrated prognostic model using significant baseline variables was proposed.
Results
There were 121 patients with baseline ctDNA and matched tumor tissues enrolled in the study. A total of 417 mutations spanning 20 genes were identified in baseline tumor tissues of 119/121 (98.3 %) cases. The overall mutations in tumor tissues were completely covered by ctDNA in 52 of 121(43.0 %) patients. Baseline VAF in ctDNA but not in tumor tissues was significantly correlated to TBS of CRLM (R = 0.36, p < 0.001). Significantly longer RFS but not OS was observed in patients with lower VAF in ctDNA compared to those with higher one (p < 0.001 and p = 0.33 respectively). Multivariate Cox regression analysis showed higher VAF in baseline ctDNA was an independent risk factor for RFS. An integrated prognostic model including baseline metastasis location and VAF in ctDNA outperformed the traditional CRS model in predicting RFS.
Conclusion
Baseline VAF in ctDNA but not in tumor tissues influenced RFS of CRLM patients after curative resection.
{"title":"Comparing baseline VAF in circulating tumor DNA and tumor tissues predicting prognosis of patients with colorectal cancer liver metastases after curative resection","authors":"Ke-min Jin , Quan Bao , Ting-ting Zhao , Hong-wei Wang , Long-fei Huang , Kun Wang , Bao-cai Xing","doi":"10.1016/j.clinre.2024.102464","DOIUrl":"10.1016/j.clinre.2024.102464","url":null,"abstract":"<div><h3>Introduction</h3><div>The prognostic value of baseline variant allele frequency (VAF) in circulating tumor DNA (ctDNA) of colorectal cancer liver metastases (CRLM) patients after curative resection was rarely investigated.</div></div><div><h3>Methods</h3><div>A single-center prospective study was performed to investigate the prognostic impact of baseline VAF in ctDNA and matched tumor tissues of CRLM patients after curative resection between May 2019 and May 2021 by the Illumina NovoSeq 6000 platform. The relationship of the tumor burden score (TBS) and the VAF in ctDNA and matched tumor tissues was evaluated by the Pearson correlation method. The survival curves of recurrence-free survival (RFS) and overall survival (OS) were plotted. Factors associated with RFS were calculated using Cox regression analysis, and an integrated prognostic model using significant baseline variables was proposed.</div></div><div><h3>Results</h3><div>There were 121 patients with baseline ctDNA and matched tumor tissues enrolled in the study. A total of 417 mutations spanning 20 genes were identified in baseline tumor tissues of 119/121 (98.3 %) cases. The overall mutations in tumor tissues were completely covered by ctDNA in 52 of 121(43.0 %) patients. Baseline VAF in ctDNA but not in tumor tissues was significantly correlated to TBS of CRLM (<em>R</em> = 0.36, <em>p</em> < 0.001). Significantly longer RFS but not OS was observed in patients with lower VAF in ctDNA compared to those with higher one (<em>p</em> < 0.001 and <em>p</em> = 0.33 respectively). Multivariate Cox regression analysis showed higher VAF in baseline ctDNA was an independent risk factor for RFS. An integrated prognostic model including baseline metastasis location and VAF in ctDNA outperformed the traditional CRS model in predicting RFS.</div></div><div><h3>Conclusion</h3><div>Baseline VAF in ctDNA but not in tumor tissues influenced RFS of CRLM patients after curative resection.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 9","pages":"Article 102464"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281409","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}
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