Gastroenterology and Hepatology From Bed to Bench最新文献

Aim: The primary objective was to assess the relationship between the citation number and the quality of the articles, as compared with the level of evidence and the MINORS score. This study's secondary objective was to characterize the 50 most cited articles in the field of oesophagectomy research.

Background: There has been an increased need for an evaluation tool to indicate research quality. Available quality assessment tools include the Level of Evidence, the MINORS score, the Cochrane Risk of Bias 2.0 Tool, the Newcastle Ottawa Scale, CASP Appraisal Checklists, and Legend Evidence Evaluation tools.

Methods: The Web of Science allowed evaluating and comparing articles on oesophagectomy research. The quality of the 50 most cited articles was assessed using the Oxford Centre level of evidence classification and the methodological index for non-randomized studies (MINORS).

Results: Level of evidence II studies were cited more than level IV (P=0.008). There was a significant positive correlation between citation number and MINORS score (P=0.002). The median MINORS score was highest amongst level II studies, followed by levels III, IV, and I. The median MINORS score for level II evidence was significantly higher than for level IV (P=0.001). The study sample size is associated with higher levels of evidence but does not correlate with the citation number. Female authors contributed to 4 out of 50 articles. Recently published articles tended to be cited more frequently. More authors equated to more citations. Prospective studies are more likely to be cited.

Conclusion: Citation analysis can be used as an indicator of quality when assessing articles. It should, however, be used with caution as highly cited work, famous authors, and journals are all more likely to be cited. Citation analysis should be used alongside other well-established tools.

Aim: The aim of this study was to translate and cross-culturally adapt the Constipation Severity Instrument (CSI) and assess its reliability and validity in the Iranian Persian language with chronic functional constipation.

Background: Chronic functional constipation is a common complaint characterized by a range of symptoms. The use of a validated tool adapted to the culture is an important part of the treatment process.

Methods: CSI was translated into Persian language according to Beaton's guidelines. One hundred and twenty-five patients with chronic functional constipation, according to ROME IV criteria, completed the questionnaires. Face validity was assessed in two qualitative and quantitative forms (impact score), internal consistency and test-retest reliability were assessed by Cronbach's alpha coefficient and intraclass correlation coefficient (ICC), respectively. Convergent validity was assessed by correlating the total scores of the CSI and the WCSS. The floor/ ceiling effects of the questionnaire were also assessed.

Results: The impact score of all questions was greater than 1.5. The Cronbach's alpha coefficient for the total score was 0.90 and the ICC was 0.90. The total score of the CSI was significantly correlated with the total score of the WCSS (Spearman's p=0.74). No floor/ceiling effects were found.

Conclusion: The Persian version of the CSI is a reliable and valid tool that can be used for psychometric evaluation. Clinicians can also benefit from this questionnaire when assessing treatment outcomes in Iranian patients.

Aim: The purpose of the study was to assess benefits of oral midodrine in the role of primary prevention of hepatorenal syndrome (HRS) in Child-Turcotte-Pugh Class C (CTP-C) cirrhotics.

Background: The present non-randomized pilot study was designed for primary prevention of HRS as there is absence of an effective and definite treatment for this complication of cirrhosis to date other than liver transplant (LT).

Methods: This study effectively involved 30 patients each enrolled in interventional and control arms suffering from liver cirrhosis CTP-C with normal renal function and having a mean arterial pressure (MAP) < 80 mmHg who were subjected to clinical examination and baseline blood investigations. The mean daily dosage of midodrine used across the study group was 16.75 mg.

Results: At the end of 4 months of study, 11 individuals completed the study without attaining any endpoints from the control group while 23 accomplished it from the interventional arm. Nearly 50 % patients required a midodrine dose of 7.5 mg 8th hourly while the rest attained the targeted MAP with lower doses. By increasing MAP, the rate of HRS development during the study period (i.e. 4 months) was found to be significantly reduced in patients from interventional arm. The number needed to treat (NNT) observed in survival analysis to prevent one death was found to be 7.6.

Conclusion: This study successfully established the role oral midodrine in primary prevention of HRS in cirrhotics at high risk. Midodrine was well tolerated with no significant adverse effects in patients under study.

Aim: This study was conducted to discover the effect of NCAPD3 knockdown on the gene expression profile of gastric cancer.

Background: Gastric cancer, a potentially fatal disease, requires thorough evaluation for targeted interventions. Through the post-analysis of microarray data, it is crucial to further examine the impact of NCAPD3 (Non-SMC condensin II complex subunit D3) inhibition in gastric cancer, emphasizing the need for a more comprehensive analysis of this knockdown.

Methods: The use of Cytoscape and its plug-ins for protein-protein interaction network analysis enables the identification of genes that significantly affect network stability. These hub-bottlenecks are regulated due to the NCAPD3 inhibition and some of them act as compensators in this condition. The hub-bottlenecks pathways identified by ClueGO indicate their relationships in underlying mechanisms of knockdown. These identified central differentially expressed genes could be considered eligible targets for therapeutic interventions. Some of them play compensative roles while others are regulated in NCAPD3 knockdown.

Results: It can be concluded that some of the hub-bottlenecks contribute to compensation mechanisms including NPM1, PTEN, EGFR, HSPA5, and ASNS, while the other ones including HSPA4, DHX9, CAV1, MAP1LC3B, and SRSF1 are among the regulated genes.

Conclusion: In particular, the up-regulation of EGFR and ASNS genes in the knockdown scenario could significantly impact and deteriorate cancer treatment outcomes after comprehensive validation studies.

Aim: We assessed the feasibility of point-of-care testing to gain insights into participants' knowledge, experience and its effect on hepatitis C management.

Background: In New Zealand, only 50% of people infected with hepatitis C (HCV) are currently diagnosed. HCV infection is the most common diagnosis leading to liver transplantation in New Zealand. A point-of-care test can streamline HCV management.

Methods: The OraQuick HCV test (mouth swab or finger-prick) was offered to participants aged 45 to 65 and anyone with a risk factor for hepatitis C. Data collected included demographics, risk factors, and participant experience with testing.

Results: A total of 218 participants were recruited. The median age was 29 years (IQR 22 to 46). All the tests via the finger-prick method were negative. Fourteen positive mouth-swab tests were negative on ELISA testing. One person was detected to have HCV infection and treated. Knowledge regarding HCV was low. There were no statistically significant differences in knowledge between participants with different education levels, F (4213=0.857, P=0.491 and different ethnicities, F (4,213)0.857, P=0.491. The majority of study participants preferred the point-of-care test.

Conclusion: Point-of-care testing for HCV is feasible and preferred. Knowledge regarding HCV was low. This study has also provided valuable insights into the viability and experience of offering point-of-care testing.

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients.

Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management.

Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial.

Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SF-LDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62).

Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms.

Aim: In this study, we intend to evaluate the occurrence of small fiber neuropathy in patients with irritable bowel syndrome (IBS).

Background: Small fiber neuropathy (SFN) is a sensory neuropathy that results from the degeneration of small Aδ and unmyelinated C fibers. SFN manifests positive symptoms, such as tingling, burning, prickling, and aching, and negative symptoms, including numbness, tightness, and coldness. The SFN coexistence with other comorbidities (e.g., fibromyalgia, inflammatory bowel disease, celiac disease) has been reported in previous studies.

Methods: We conducted a cross-sectional study to assess the coexistence of SFN and IBS. Forty-two IBS patients and forty-three healthy individuals were asked to complete the Michigan Neuropathy Screening Instrument (MNSI) questionnaire. Results greater than three (>3) were considered positive. Participants with positive MNSI questionnaire results were examined for any neuropathy signs according to the Utah Early Neuropathy Scale (UENS) examination. The participants with positive results for the questionnaire and examination were checked for the sural and the superficial peroneal nerve conduction study (NCS). Normal NCS represented intact large fibers and the diagnosis of SFN.

Results: Ten participants, 7 (16.7 %) in the IBS group and 3 (6.9 %) in the healthy group, had positive results for the questionnaire. Four participants were positive for the examination, with normal NCS, and were classified as SFN-positive. All four SFN diagnoses were from the IBS group. No one in the healthy group was diagnosed with SFN. We could find a significant statistical difference (p<0.05) between the IBS and healthy groups regarding the prevalence of SFN diagnosis.

Conclusion: The co-occurrence of SFN and IBS suggests the possibility of a generalized neuropathy syndrome characterized by widespread neuronal impairment. Thus, any peripheral neuropathy symptom in IBS patients (and potentially other chronic pain disorders) should be evaluated for SFN since timely diagnosis and proper treatment result in a better quality of life for the patients.

Weight gain post-liver transplant can lead to adverse patient outcomes in the post-transplant period. Pharmacotherapy and other measures can be utilised to reduce the burden and occurrence of weight gain in this population. We explored the mechanism of action, safety, and efficacy of these medications, specifically GLP-1 receptor agonists and metformin, focusing on liver transplant patients. This scoping review was conducted in line with the scoping review structure as outlined by the PRISMA guidelines. Metformin and GLP-1 receptor agonists have been observed to be safe and effective in liver transplant patients. Experimental models have found liver-centric weight loss mechanisms in this drug cohort. There is a paucity of evidence about the use of antihyperglycemics in a post-transplant population for weight loss purposes. However, some small studies have shown strong safety and efficacy data. The evidence in relation to using these medications in patients with metabolic syndrome for weight loss warrants further study in a transplant population.

Aim: This systematic review and meta-analysis aimed to assess the effect of hydrogen-rich water (HRW) on liver enzyme levels.

Background: Liver disease is a significant global health concern, greatly affecting mortality rates. Elevated levels of liver enzymes, such as ALT, AST, ALP, and GGT are early symptoms of liver disorders, and various approaches can help reduce them. Recent studies have shown the prospective therapeutic advantages of hydrogen as an antioxidant and anti-inflammatory agent in many circumstances.

Methods: The search strategy was developed following PRISMA guidelines. PubMed, Google Scholar, and Embase were searched from the beginning to January 2024. Eight Randomized controlled trial (RCT) studies were included, encompassing 433 participants with various liver function disorders.

Results: Our results showed a slight decrease in ALT, AST, and ALP levels in the treated group with HRW compared to the PW group.

Conclusion: Our findings suggest that consuming HRW may decrease liver enzyme levels in clinical populations. Further research is needed to confirm this relationship.