Pub Date : 2025-12-01Epub Date: 2025-11-04DOI: 10.1016/j.clinre.2025.102727
Anthony Buisson , Jérémy Denizot
{"title":"Adherent-invasive E. coli (AIEC) in Crohn’s disease: where are we in 2025? Tribute to Professor Nicolas Barnich","authors":"Anthony Buisson , Jérémy Denizot","doi":"10.1016/j.clinre.2025.102727","DOIUrl":"10.1016/j.clinre.2025.102727","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102727"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457816","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}
Durvalumab in combination with gemcitabine/cisplatin (GemCis) has expanded therapeutic options for advanced biliary tract cancers (BTCs), raising both clinical and economic considerations. We aim to describe the efficacy, safety and economic impact of durvalumab addition.
Methods
This retrospective study analyzed cohorts of patients receiving GemCis ± durvalumab. Progression-Free Survival (PFS) and Overall Survival (OS) were estimated using the Kaplan–Meier method. The economic impact of different dosing strategies was explored through scenario-based analyses.
Results
Median PFS was 7.4 months (95 %CI: 5.4–10.8) in the GemCis-durvalumab group and 6.1 months (95 %CI: 4.0–7.1) in the GemCis group. Median OS was 10.0 months (95 %CI: 5.9–12.8) and 9.7 months (95 %CI: 6.5–12.8), respectively. No severe immune related adverse events were reported. The median treatment cost per patient was €36,342 for GemCis-Durvalumab versus €173 for GemCis alone. Economic analysis suggested that adjusting durvalumab dosing (20mg/kg instead of a flat dose) could lead to saved costs of €344 to €2547 per infusion without affecting outcomes.
Conclusions
This study confirms effectiveness of durvalumab, aligning with clinical trial results. However, the substantial economic burden underscores the importance of optimizing dosing strategies. The recent approval of pembrolizumab further highlights the need for prospective cost-benefit comparisons studies incorporating predictive biomarkers.
{"title":"Clinical and economic outcomes of adding durvalumab to gemcitabine/cisplatin in advanced biliary tract cancers: A multicenter descriptive study","authors":"Lena Luciani , Claire Carlier , Léonie Leuk , Justine Clarenne , Violaine Lepage , Marine Perrier , Olivier Bouché , Elia Gigante , Florian Slimano","doi":"10.1016/j.clinre.2025.102733","DOIUrl":"10.1016/j.clinre.2025.102733","url":null,"abstract":"<div><h3>Background</h3><div>Durvalumab in combination with gemcitabine/cisplatin (GemCis) has expanded therapeutic options for advanced biliary tract cancers (BTCs), raising both clinical and economic considerations. We aim to describe the efficacy, safety and economic impact of durvalumab addition.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed cohorts of patients receiving GemCis ± durvalumab. Progression-Free Survival (PFS) and Overall Survival (OS) were estimated using the Kaplan–Meier method. The economic impact of different dosing strategies was explored through scenario-based analyses.</div></div><div><h3>Results</h3><div>Median PFS was 7.4 months (95 %CI: 5.4–10.8) in the GemCis-durvalumab group and 6.1 months (95 %CI: 4.0–7.1) in the GemCis group. Median OS was 10.0 months (95 %CI: 5.9–12.8) and 9.7 months (95 %CI: 6.5–12.8), respectively. No severe immune related adverse events were reported. The median treatment cost per patient was €36,342 for GemCis-Durvalumab versus €173 for GemCis alone. Economic analysis suggested that adjusting durvalumab dosing (20mg/kg instead of a flat dose) could lead to saved costs of €344 to €2547 per infusion without affecting outcomes.</div></div><div><h3>Conclusions</h3><div>This study confirms effectiveness of durvalumab, aligning with clinical trial results. However, the substantial economic burden underscores the importance of optimizing dosing strategies. The recent approval of pembrolizumab further highlights the need for prospective cost-benefit comparisons studies incorporating predictive biomarkers.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102733"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573305","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 : 2025-12-01Epub Date: 2025-10-23DOI: 10.1016/j.clinre.2025.102715
Jia-Lu Long, Peng Liu
{"title":"Gastrointestinal stromal tumor presenting in the pancreas","authors":"Jia-Lu Long, Peng Liu","doi":"10.1016/j.clinre.2025.102715","DOIUrl":"10.1016/j.clinre.2025.102715","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102715"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370174","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}
To evaluate the prevalence, diagnostic criteria, and predictive factors of cirrhotic cardiomyopathy (CCMP) in pediatric patients with portal hypertension (PHTN), using electrocardiography (ECG), echocardiography, and NT-proBNP levels.
Methods
This cross-sectional study included 54 children with portal hypertension (45 with cirrhosis and 9 without), and 54 age- and sex-matched healthy controls. All participants underwent ECG, echocardiography, and NT-proBNP testing. CCMP was diagnosed based on the Møller-Henriksen criteria. Demographic, clinical, and laboratory variables, including PELD/MELD and Child-Pugh scores, were analyzed. Logistic regression was used to identify predictors of CCMP.
Results
CCMP was identified in 14 cirrhotic patients (31.1 %), with 9 symptomatic and 5 silent cases. No cases were observed among non-cirrhotic patients or controls. The presence of ascites and higher PELD/MELD scores were significantly associated with CCMP. QTc prolongation and reduced ejection fraction were key diagnostic findings. Systolic dysfunction was present in 3 patients, and 4 patients with CCMP died before or shortly after liver transplantation. Multivariate analysis confirmed PELD/MELD score as a significant predictor of CCMP (OR 1.19; 95 % CI 1.038–1.367; p=0.01).
Conclusion
Cirrhotic cardiomyopathy is a prevalent but often silent complication in children with cirrhosis and PHTN. Elevated PELD/MELD scores and the presence of ascites are important predictive factors. Routine cardiac evaluation using ECG, echocardiography, and biomarkers like NT-proBNP is recommended for early detection and risk stratification in this population.
Main Points
Cirrhotic cardiomyopathy (CCMP) is an uncommon yet serious condition in children with liver disease. Current diagnostic criteria require reassessment for pediatric use, particularly considering regional genetic and environmental differences.
目的：通过心电图（ECG）、超声心动图和NT-proBNP水平评估门脉高压（PHTN）患儿肝硬化心肌病（CCMP）的患病率、诊断标准和预测因素。方法：本横断面研究纳入54例门静脉高压症患儿（45例合并肝硬化，9例未合并肝硬化）和54例年龄和性别匹配的健康对照。所有参与者都进行了心电图、超声心动图和NT-proBNP测试。CCMP的诊断基于Møller-Henriksen标准。分析了人口统计学、临床和实验室变量，包括PELD/MELD和Child-Pugh评分。采用Logistic回归确定CCMP的预测因素。结果：14例肝硬化患者（31.1%）发现CCMP，其中9例有症状，5例无症状。在非肝硬化患者或对照组中未观察到病例。腹水的存在和较高的PELD/MELD评分与CCMP显著相关。QTc延长和射血分数降低是主要的诊断结果。3例患者出现收缩功能障碍，4例CCMP患者在肝移植前或移植后不久死亡。多因素分析证实PELD/MELD评分是CCMP的重要预测因子（OR 1.19; 95% CI 1.038 ~ 1.367; p=0.01）。结论：肝硬化心肌病是肝硬化和PHTN患儿的一种常见但通常不明显的并发症。PELD/MELD评分升高和腹水的存在是重要的预测因素。建议使用心电图、超声心动图和NT-proBNP等生物标志物进行常规心脏评估，以便在该人群中进行早期发现和风险分层。要点：肝硬化心肌病（CCMP）是一种罕见但严重的儿童肝脏疾病。目前的诊断标准需要重新评估儿科使用，特别是考虑到区域遗传和环境差异。
{"title":"Cirrhotic cardiomyopathy in children: A comprehensive assessment using ECG, echocardiography, and NT-Pro-BNP","authors":"Ataollahi Maryam , Naghshzan Amir , Haghighat Mahmood , Dehghani Mohsen , Amuzgar Hamid , Kalvandi Gholamreza , Mehdizadegan Nima , Salarian Leila","doi":"10.1016/j.clinre.2025.102721","DOIUrl":"10.1016/j.clinre.2025.102721","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prevalence, diagnostic criteria, and predictive factors of cirrhotic cardiomyopathy (CCMP) in pediatric patients with portal hypertension (PHTN), using electrocardiography (ECG), echocardiography, and NT-proBNP levels.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 54 children with portal hypertension (45 with cirrhosis and 9 without), and 54 age- and sex-matched healthy controls. All participants underwent ECG, echocardiography, and NT-proBNP testing. CCMP was diagnosed based on the Møller-Henriksen criteria. Demographic, clinical, and laboratory variables, including PELD/MELD and Child-Pugh scores, were analyzed. Logistic regression was used to identify predictors of CCMP.</div></div><div><h3>Results</h3><div>CCMP was identified in 14 cirrhotic patients (31.1 %), with 9 symptomatic and 5 silent cases. No cases were observed among non-cirrhotic patients or controls. The presence of ascites and higher PELD/MELD scores were significantly associated with CCMP. QTc prolongation and reduced ejection fraction were key diagnostic findings. Systolic dysfunction was present in 3 patients, and 4 patients with CCMP died before or shortly after liver transplantation. Multivariate analysis confirmed PELD/MELD score as a significant predictor of CCMP (OR 1.19; 95 % CI 1.038–1.367; p=0.01).</div></div><div><h3>Conclusion</h3><div>Cirrhotic cardiomyopathy is a prevalent but often silent complication in children with cirrhosis and PHTN. Elevated PELD/MELD scores and the presence of ascites are important predictive factors. Routine cardiac evaluation using ECG, echocardiography, and biomarkers like NT-proBNP is recommended for early detection and risk stratification in this population.</div></div><div><h3>Main Points</h3><div>Cirrhotic cardiomyopathy (CCMP) is an uncommon yet serious condition in children with liver disease. Current diagnostic criteria require reassessment for pediatric use, particularly considering regional genetic and environmental differences.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102721"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408441","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 : 2025-12-01Epub Date: 2025-11-05DOI: 10.1016/j.clinre.2025.102729
Vincent Zimmer , Roland Heyny-von Haußen
{"title":"Discrete, but devastating: duodenal lymphangiosis carcinomatosa","authors":"Vincent Zimmer , Roland Heyny-von Haußen","doi":"10.1016/j.clinre.2025.102729","DOIUrl":"10.1016/j.clinre.2025.102729","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102729"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470840","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 : 2025-12-01Epub Date: 2025-11-17DOI: 10.1016/j.clinre.2025.102732
Oscar Corsi , Constanza Jara , Magdalena Fernandez , Antonia Pastore , Diego Pérez , Alonso Valdes , Álvaro Huete , Eduardo Briceño , Juan Pablo Arab , Francisco Barrera , Marco Arrese , Roberto Candia
Background
: Cholecystectomy due to gallstones is one of the most frequent surgeries worldwide. Observational studies suggest that cholecystectomy may be a risk factor for metabolic dysfunction associated with steatotic liver disease (MASLD). However, gallstone disease and MASLD share common risk factors, which could make cholecystectomy a confounder.
Aim
To assess the relationship among cholecystectomy, gallstones, and MASLD in a longitudinal cohort study from a population at high risk of gallbladder diseases.
Methods
A longitudinal retrospective cohort study compared consecutive patients undergoing cholecystectomy with a control group composed of patients with their gallbladder intact. All participants had normal liver imaging and biochemistry at baseline. Participants with incomplete clinical records or significant alcohol consumption were excluded. The primary outcome was the development of MASLD after a follow-up of at least 3 years. Cox regression models were used to conduct multivariable analyses.
Results
We included 427 participants 132 in the cholecystectomy group and 295 controls. The mean age was 47.2 years, with 71.7% being female, and 43.6% having gallstone disease. The median follow-up was 9.7 years. In the Cox multivariate analysis, male gender (aHR: 1.56 [1.09-2.24]), gallstone disease (aHR: 2.18 [1.42-3.36]), prediabetes (aHR: 1.56 [1.06-2.3]), diabetes (aHR: 2.39 [1.38-4.13]), and overweight/obesity (aHR: 5.7 [3.19-10.21]) were independent risk factors for MASLD. After adjustment, cholecystectomy was not associated with MASLD incidence (aHR: 0.68 [0.44-1.03]). Sensitivity analyses supported these findings.
Conclusion
Cholecystectomy was not found to significantly influence the incidence of MASLD after adjusting for metabolic risk factors. The risk of developing MASLD is likely driven by metabolic factors and previous gallstone disease.
{"title":"Is cholecystectomy a real risk factor for Metabolic dysfunction-associated steatotic liver disease (MASLD)? A longitudinal cohort study from a population with a high burden of gallbladder diseases","authors":"Oscar Corsi , Constanza Jara , Magdalena Fernandez , Antonia Pastore , Diego Pérez , Alonso Valdes , Álvaro Huete , Eduardo Briceño , Juan Pablo Arab , Francisco Barrera , Marco Arrese , Roberto Candia","doi":"10.1016/j.clinre.2025.102732","DOIUrl":"10.1016/j.clinre.2025.102732","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Cholecystectomy due to gallstones is one of the most frequent surgeries worldwide. Observational studies suggest that cholecystectomy may be a risk factor for metabolic dysfunction associated with steatotic liver disease (MASLD). However, gallstone disease and MASLD share common risk factors, which could make cholecystectomy a confounder.</div></div><div><h3>Aim</h3><div>To assess the relationship among cholecystectomy, gallstones, and MASLD in a longitudinal cohort study from a population at high risk of gallbladder diseases.</div></div><div><h3>Methods</h3><div>A longitudinal retrospective cohort study compared consecutive patients undergoing cholecystectomy with a control group composed of patients with their gallbladder intact. All participants had normal liver imaging and biochemistry at baseline. Participants with incomplete clinical records or significant alcohol consumption were excluded. The primary outcome was the development of MASLD after a follow-up of at least 3 years. Cox regression models were used to conduct multivariable analyses.</div></div><div><h3>Results</h3><div>We included 427 participants 132 in the cholecystectomy group and 295 controls. The mean age was 47.2 years, with 71.7% being female, and 43.6% having gallstone disease. The median follow-up was 9.7 years. In the Cox multivariate analysis, male gender (aHR: 1.56 [1.09-2.24]), gallstone disease (aHR: 2.18 [1.42-3.36]), prediabetes (aHR: 1.56 [1.06-2.3]), diabetes (aHR: 2.39 [1.38-4.13]), and overweight/obesity (aHR: 5.7 [3.19-10.21]) were independent risk factors for MASLD. After adjustment, cholecystectomy was not associated with MASLD incidence (aHR: 0.68 [0.44-1.03]). Sensitivity analyses supported these findings.</div></div><div><h3>Conclusion</h3><div>Cholecystectomy was not found to significantly influence the incidence of MASLD after adjusting for metabolic risk factors. The risk of developing MASLD is likely driven by metabolic factors and previous gallstone disease.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102732"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556324","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}
{"title":"Update on IBD management: What's new in acute severe UC? - Modern management of perianal disease","authors":"David Laharie , Pauline Rivière , Amandine Landemaine , Guillaume Bouguen","doi":"10.1016/j.clinre.2025.102725","DOIUrl":"10.1016/j.clinre.2025.102725","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102725"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421362","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 : 2025-12-01Epub Date: 2025-11-04DOI: 10.1016/j.clinre.2025.102730
Jingxia Yu , Wenhui Xia , Lei Xu , Qianqian Wang , Yuxuan Chen , Shuo Zhang
{"title":"A fishbone hidden for 2 months: Successfully located by endoscopic ultrasound and removed by submucosal tunnel endoscopic resection","authors":"Jingxia Yu , Wenhui Xia , Lei Xu , Qianqian Wang , Yuxuan Chen , Shuo Zhang","doi":"10.1016/j.clinre.2025.102730","DOIUrl":"10.1016/j.clinre.2025.102730","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102730"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457907","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 : 2025-11-01Epub Date: 2025-10-09DOI: 10.1016/j.clinre.2025.102711
Vincent Zimmer , Kristina Welte
{"title":"A strawberry-like polyp in the rectum","authors":"Vincent Zimmer , Kristina Welte","doi":"10.1016/j.clinre.2025.102711","DOIUrl":"10.1016/j.clinre.2025.102711","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102711"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257533","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 : 2025-11-01Epub Date: 2025-10-09DOI: 10.1016/j.clinre.2025.102710
Luca Marzi , Federica de Marchi , Francesco Erdini , Chiara Turri , Monica Zoeschg , Andrea Mega
{"title":"Salvage use of tacrolimus in steroid-refractory severe immune hepatitis from vulvar melanoma immunotherapy","authors":"Luca Marzi , Federica de Marchi , Francesco Erdini , Chiara Turri , Monica Zoeschg , Andrea Mega","doi":"10.1016/j.clinre.2025.102710","DOIUrl":"10.1016/j.clinre.2025.102710","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 9","pages":"Article 102710"},"PeriodicalIF":2.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257521","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号