JGH Open最新文献_第10页

Celiac disease is associated with increased risk of deep vein thrombosis and hypotensive shock in patients admitted with acute pancreatitis 乳糜泻与急性胰腺炎患者深静脉血栓形成和低血压休克的风险增加有关。

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-24 DOI: 10.1002/jgh3.70017

Yazan Abboud, Vraj P Shah, Yi Jiang, Navya Pendyala, Kaveh Hajifathalian

Background and Aim

Celiac disease (CD) was shown to be associated with increased risk of developing acute pancreatitis (AP). There is a paucity of literature critically analyzing the association of CD with AP outcomes. We aimed to evaluate the impact of CD on outcomes and complications of AP in recent years.

Methods

A population-based analysis was performed using the National Inpatient Sample (NIS) between 2016 and 2019. Multivariable logistic regression was conducted to identify the independent impact of CD on AP outcomes while controlling for demographics and comorbidities and all patients refined diagnosis-related groups (APR-DRG) risk of severity subclass.

Results

From 2016 to 2019, a total of 2 253 730 inpatients with AP were identified, of which 4640 (0.2%) had CD. On multivariable analysis, while controlling for demographics, comorbidities, and severity of illness, CD patients had significantly decreased odds for mortality (OR = 0.387), pseudocyst formation (OR = 0.786), sepsis (OR = 0.707), respiratory failure (OR = 0.806), acute kidney injury (AKI) (OR = 0.804), and myocardial infarction (OR = 0.217), (P < 0.05). However, CD patients were at significantly increased odds for deep vein thrombosis (DVT) (OR = 2.240) and hypotensive shock (OR = 1.718) (P < 0.05). Patients with CD had shorter lengths of stay by 0.4 days and lower total charges by $12 690.

Conclusions

Our nationwide study evaluating AP outcomes in patients with CD suggests that patients with CD admitted for AP tend to have better mortality and several other outcomes compared to non-CD patients. We also show that CD patients admitted for AP have a greater risk for DVT and hypotensive shock. Future studies are warranted to validate the revealed findings in CD patients admitted for AP.

背景和目的：研究表明，乳糜泻（CD）与急性胰腺炎（AP）发病风险增加有关。批判性分析 CD 与急性胰腺炎预后相关性的文献极少。我们旨在评估近年来 CD 对急性胰腺炎预后和并发症的影响：我们利用 2016 年至 2019 年间的全国住院患者样本（NIS）进行了一项基于人群的分析。在控制人口统计学、并发症和所有患者细化诊断相关组（APR-DRG）严重性风险亚类的同时，进行了多变量逻辑回归，以确定 CD 对 AP 结局的独立影响：从2016年到2019年，共发现2 253 730名AP住院患者，其中4640人（0.2%）患有CD。经多变量分析，在控制人口统计学、合并症和病情严重程度的情况下，CD 患者的死亡率（OR = 0.387）、假性囊肿形成（OR = 0.786）、脓毒症（OR = 0.707）、呼吸衰竭（OR = 0.806）、急性肾损伤（AKI）（OR = 0.804）和心肌梗死（OR = 0.217）的几率显著降低，（P P 结论：我们在全国范围内对 CD 患者的急性肾功能衰竭预后进行的评估研究表明，与非 CD 患者相比，因急性肾功能衰竭入院的 CD 患者的死亡率和其他几项预后往往更好。我们还发现，因 AP 而入院的 CD 患者发生深静脉血栓和低血压休克的风险更高。今后有必要对因 AP 而入院的 CD 患者进行研究，以验证所揭示的发现。

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引用次数: 0

Is there an “optimal” diet for prevention of inflammatory bowel disease? 有没有预防炎症性肠病的 "最佳 "饮食？

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-24 DOI: 10.1002/jgh3.70016

Chu K Yao, Jessica Fitzpatrick, Priscila Machado, Heidi M Staudacher

Nutritional epidemiological studies have evolved from a focus of single nutrients to diet patterns to capture the protective role of healthy diets on chronic disease development. Similarly, in inflammatory bowel disease (IBD), a healthy diet may be protective against its development in individuals with genetic susceptibility, but the definitions of the optimal diet pattern deserve further exploration. Hence, this review article presents evidence, mainly from prospective cohort studies, for the role of diet quality based on adherence to dietary guidelines, traditional and modern diet patterns in the prevention of IBD. Findings from a limited number of studies on diet quality suggest that high diet quality scores are associated with lower risk of developing Crohn's disease, but the data are inconsistent for ulcerative colitis (UC). There are signals that a Mediterranean diet pattern reduces the risk of Crohn's disease but, again, the data are inconsistent and further studies are much needed. Finally, the evidence is conflicting regarding the role of food additives, with difficulties in the assessment of their intake, namely non-nutritive sweeteners and emulsifiers, precluding accurate assessment of a relationship with IBD risk. In contrast, emerging evidence for a role of ultra-processed food in the development of Crohn's disease but not UC is identified. Given the potential influence of diet quality, a Mediterranean diet and ultra-processed food intake on the risk of Crohn's disease, assessment and implementation of dietary advice for these patients need to be tailored. The search for an optimal diet for UC remains elusive and further research for increasing the evidence in the area is greatly needed.

营养流行病学研究已从关注单一营养素发展到膳食模式，以捕捉健康膳食对慢性疾病发展的保护作用。同样，在炎症性肠病（IBD）中，健康饮食可能对具有遗传易感性的个体的发病具有保护作用，但最佳饮食模式的定义值得进一步探讨。因此，本综述文章主要通过前瞻性队列研究提供证据，说明基于膳食指南的膳食质量、传统和现代膳食模式在预防 IBD 中的作用。数量有限的有关饮食质量的研究结果表明，饮食质量得分高的人患克罗恩病的风险较低，但有关溃疡性结肠炎（UC）的数据并不一致。有迹象表明，地中海饮食模式可降低罹患克罗恩病的风险，但数据同样不一致，亟需进一步研究。最后，有关食品添加剂作用的证据相互矛盾，由于难以评估食品添加剂（即非营养性甜味剂和乳化剂）的摄入量，因此无法准确评估其与 IBD 风险的关系。与此相反，有新的证据表明，超加工食品在克罗恩病的发病中起作用，而不是在 UC 的发病中起作用。鉴于饮食质量、地中海饮食和超加工食品摄入对克罗恩病风险的潜在影响，需要对这些患者的饮食建议进行有针对性的评估和实施。寻找治疗 UC 的最佳饮食仍然遥遥无期，因此亟需进一步研究以增加该领域的证据。

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引用次数: 0

Sleep quality is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain 睡眠质量通过与疼痛的相互作用，与炎症性肠病患者生活质量下降有关

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-24 DOI: 10.1002/jgh3.70021

Alex Barnes, Robert V Bryant, Sutapa Mukherjee, Paul Spizzo, Réme Mountifield

Background and Aim

Quality of life is reduced in people with inflammatory bowel disease (IBD) and poor sleep is prevalent in people with IBD. This study aimed to investigate the influence of sleep on quality of life (QoL) in people with inflammatory bowel disease.

Methods

An online questionnaire was administered through three tertiary IBD centers, social media, and through Crohn's Colitis Australia. The questionnaire included the EQ-5D-5L measures of health-related QoL, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index (PSQI), and validated IBD activity and mental health scores.

Results

There were 553 responses included with a diagnosis of Crohn's disease (62.2%), with over half on biologic therapy (53.1%). Poor sleep and clinically significant insomnia were associated with lower QoL (EQ-5D-5L scores: EQVAS, utility score, P < 0.001 for all). Sleep quality scores correlated with the EQ-5D-5L domains of “pain” (ρ 0.35, P < 0.001), “usual activities” (ρ 0.32, P < 0.001), and “depression-anxiety” (ρ 0.37, P < 0.001). After adjusting for demographic variables, IBD activity, and depression and anxiety via multivariate regression, the “pain” domain continued to be associated with PSQI components “sleep quality” (P < 0.001), “sleep disturbance” (P < 0.001), and “sleep duration” (P < 0.001). Clinically significant insomnia was associated with a reduction in QoL (EQVAS, utility score) independent of IBD activity (P < 0.001) and of a similar magnitude to that seen with IBD activity.

Conclusion

Health-related QoL in IBD is influenced by aspects of sleep quality irrespective of IBD activity and mental health conditions. The presence of insomnia is associated with a reduction in health-related QoL. Consideration should be given to sleep targeting interventional studies in an IBD population.

背景和目的炎症性肠病（IBD）患者的生活质量会下降，而睡眠质量差在 IBD 患者中很普遍。本研究旨在调查睡眠对炎症性肠病患者生活质量（QoL）的影响。方法通过三家三级 IBD 中心、社交媒体以及澳大利亚克罗恩结肠炎协会进行在线问卷调查。问卷包括 EQ-5D-5L 健康相关 QoL 测量、失眠严重程度指数、匹兹堡睡眠质量指数 (PSQI) 以及经验证的 IBD 活动和心理健康评分。结果有 553 人被诊断为克罗恩病（62.2%），其中一半以上正在接受生物治疗（53.1%）。睡眠质量差和临床症状明显的失眠与较低的生活质量相关（EQ-5D-5L 评分：EQVAS，效用评分，所有评分的 P < 0.001）。睡眠质量得分与 EQ-5D-5L 的 "疼痛"（ρ 0.35，P < 0.001）、"日常活动"（ρ 0.32，P < 0.001）和 "抑郁-焦虑"（ρ 0.37，P < 0.001）相关。通过多变量回归对人口统计学变量、IBD 活动以及抑郁和焦虑进行调整后，"疼痛 "领域仍然与 PSQI 的 "睡眠质量"（P < 0.001）、"睡眠障碍"（P < 0.001）和 "睡眠持续时间"（P < 0.001）相关。临床症状明显的失眠与 QoL（EQVAS，效用评分）的降低有关，而与 IBD 活动无关（P < 0.001），且与 IBD 活动的影响程度相似。结论 IBD 患者与健康相关的 QoL 受睡眠质量的影响，与 IBD 活动和精神健康状况无关。失眠的存在与健康相关 QoL 的降低有关。应考虑在 IBD 患者中开展以睡眠为目标的干预研究。

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引用次数: 0

Steatosis, inflammation, fibroprogression, and cirrhosis in remnant liver post-liver donation 肝脏捐献后残余肝脏的脂肪变性、炎症、纤维增生和肝硬化

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-23 DOI: 10.1002/jgh3.70015

Jeby Jacob, Amal Joseph, Harikumar R Nair, Geevarghese Prajob Prasad, Vijosh V Kumar, Lekshmi Thattamuriyil Padmakumari

Background and Aim

This is a cross-sectional observational study conducted on living liver donors focusing on “long-term remnant liver health” specifically looking at steatosis, inflammation, and fibrosis using multiparametric ultra sonological evaluation and noninvasive blood tests.

Methods

Multiparametric ultrasound evaluation included assessment of shear wave elastography (fibrosis), sound speed plane wave ultrasound, attenuation plane wave ultrasound (steatosis), and viscosity plane wave ultrasound (inflammation). Blood test based APRI and FIB-4 were calculated. Liver biopsy was performed if noninvasive evaluation pointed toward clinically relevant fibro progression (F4).

Results

Out of 36 donors, significant fibrosis (>F2) was found in 11 donors (30.5%), seven donors (19.4%) had severe fibrosis (>F3), and two donors had shear wave elastography values suggestive of cirrhosis(F4). Of these two, one donor was extensively evaluated and was found to have biopsy proven cirrhosis with endoscopic evidence of portal hypertension. The prevalence of fatty liver disease in our study group was 50%.

Conclusion

We report the first liver donor cohort with fibroprogression and cirrhosis occurring in the remnant liver. Our donor cohort with a significant proportion having steatosis and fibroprogression underscores the importance of regular follow-up of liver donors and evaluation of remnant liver.

背景和目的这是一项针对活体肝脏捐献者的横断面观察性研究，重点关注 "长期残留肝脏健康"，特别是使用多参数超声评估和无创血液检测来观察脂肪变性、炎症和纤维化。方法多参数超声评估包括剪切波弹性成像评估（纤维化）、声速平面波超声评估、衰减平面波超声评估（脂肪变性）和粘度平面波超声评估（炎症）。计算基于血液检测的 APRI 和 FIB-4。如果无创评估显示临床相关的纤维化进展（F4），则进行肝活检。结果在 36 名供体中，11 名供体（30.5%）出现明显纤维化（F2），7 名供体（19.4%）出现严重纤维化（F3），两名供体的剪切波弹性成像值提示肝硬化（F4）。在这两名捐献者中，一名捐献者接受了广泛的评估，活检证实其患有肝硬化，内镜检查显示其患有门静脉高压症。在我们的研究小组中，脂肪肝的发病率为 50%。结论我们报告了第一例残肝纤维化和肝硬化的肝脏捐献者。我们的肝脏捐献者群体中有相当一部分人患有脂肪变性和肝纤维化，这凸显了定期随访肝脏捐献者和评估残余肝脏的重要性。

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引用次数: 0

Incidence and predicting factors of inadequate bowel preparation for colonoscopy: A cross-sectional study 结肠镜检查前肠道准备不足的发生率和预测因素：横断面研究

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-20 DOI: 10.1002/jgh3.13116

Alireza Asgari, Fateme Ziamanesh, Ali Aliasgari, Amir Ali Sohrabpour

Background and Aim

Adequate bowel preparation is necessary for optimal colonoscopy. Inadequate bowel preparation results in increased costs and imprecise colonoscopy results. This study aims to determine the incidence and risk factors of inadequate bowel preparation.

Methods

In this study, 604 consecutive patients were observed prospectively who underwent colonoscopy examination. The patient's clinical and demographic data were obtained on the day of the procedure. Bowel preparation was evaluated by Boston Bowel Preparation Scale (BBPS) and was divided into two groups; adequate and inadequate. Univariate and multivariate analyses were performed.

Results

Inadequate bowel preparation incidence was 17.9%. In the univariate analysis, education level (P value = 0.009), body mass index (P value = 0.03), admission type (P value = 0.038), previous history of colonoscopy (P value = 0.03), color and consistency of the last feces (P value = 0.03), diabetes (P value = 0.004), and smoking (P value = 0.03) were significantly related with the incidence of inadequate bowel preparation. While ischemic heart disease (IHD) decreased the level of inadequate bowel preparation (P value = 0.047). Multivariate analysis showed that diabetes mellitus (odds ratio [OR] = 2.18), smoking (OR = 2.10), inpatient status of admission type (OR = 3.32), last stool that was non-watery (OR = 1.60), and ischemic heart disease (OR = 0.032) were independent factors associated with inadequate bowel preparation.

Conclusion

Diabetic patients, smokers, inpatients and who defecated a non-watery and colory stool as the last defecation are at risk of inadequate bowel preparation and need more potent regimens. It is important to inform patients about preventable factors that affect bowel preparation to improve their preparation outcomes.

背景和目的：充分的肠道准备是进行最佳结肠镜检查的必要条件。肠道准备不足会导致费用增加和结肠镜检查结果不精确。本研究旨在确定肠道准备不足的发生率和风险因素：本研究对 604 名连续接受结肠镜检查的患者进行了前瞻性观察。患者的临床和人口统计学数据均在检查当天获得。肠道准备情况由波士顿肠道准备量表（BBPS）进行评估，并分为充分和不充分两组。进行了单变量和多变量分析：结果：肠道准备不足的发生率为 17.9%。在单变量分析中，教育水平（P 值 = 0.009）、体重指数（P 值 = 0.03）、入院类型（P 值 = 0.038）、既往结肠镜检查史（P 值 = 0.03）、最后一次粪便的颜色和浓度（P 值 = 0.03）、糖尿病（P 值 = 0.004）和吸烟（P 值 = 0.03）与肠道准备不足的发生率显著相关。而缺血性心脏病（IHD）会降低肠道准备不足的程度（P 值 = 0.047）。多变量分析显示，糖尿病（几率比 [OR] = 2.18）、吸烟（OR = 2.10）、入院类型的住院病人状态（OR = 3.32）、最后一次大便为非水样（OR = 1.60）和缺血性心脏病（OR = 0.032）是与肠道准备不足相关的独立因素：结论：糖尿病患者、吸烟者、住院病人以及最后一次排便为非水样便和结肠便的患者有可能出现肠道准备不足的情况，需要更有效的治疗方案。让患者了解影响排便准备的可预防因素对改善他们的排便准备效果非常重要。

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引用次数: 0

Impact of fecal microbiota transplantation in severe alcoholic hepatitis: A systematic review and meta-analysis 粪便微生物群移植对重度酒精性肝炎的影响：系统回顾与荟萃分析。

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-19 DOI: 10.1002/jgh3.70007

Amira M Taha, Khaled Abouelmagd, Sarah A Nada, Abdelrahman M Mahmoud, Dang Nguyen, Sadish Sharma, Mandy Elewa

Background and Aim

Severe alcoholic hepatitis (SAH) is a serious condition with few treatments. By modifying the gut–liver axis, fecal microbiota transplantation (FMT) was proposed as a treatment for SAH. The purpose of this meta-analysis was to evaluate the efficacy of FMT versus the standard of care (SOC) in improving SAH patient survival rates.

Methods

A thorough search of electronic databases was conducted till September 2023. The survival rates of SAH patients undergoing FMT versus SOC were compared. Using Review Manager 5.4, odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Results

The meta-analysis consisted of six studies with a total of 371 patients with SAH. Patients who received FMT had significantly higher survival rates at 1 and 3 months compared to those who received SOC, with pooled OR of 2.91 (95% CI: 1.56–5.42, P = 0.0008) and 3.07 (95% CI: 1.81–5.20, P < 0.0001), respectively. However, the survival advantage disappeared after 6 months (OR: 2.96, 95% CI: 0.99–8.85, P = 0.05) and 1 year of follow-up (OR: 1.81, 95% CI: 0.44–7.46, P = 0.41).

Conclusion

This meta-analysis highlights the potential of FMT to significantly improve short-term survival rates in SAH patients. However, the survival benefit did not last 6–12 months. These findings call for additional research into the effectiveness of FMT over the long term, along with strategies for extending the survival benefit.

背景和目的：严重酒精性肝炎（SAH）是一种严重的疾病，治疗方法很少。通过改变肠道-肝脏轴，粪便微生物群移植（FMT）被认为是治疗 SAH 的一种方法。这项荟萃分析的目的是评估粪便微生物群移植与标准护理（SOC）在提高 SAH 患者存活率方面的疗效：方法：截至 2023 年 9 月，对电子数据库进行了全面检索。比较了接受 FMT 和 SOC 治疗的 SAH 患者的存活率。使用Review Manager 5.4计算了几率比（ORs）和95%置信区间（CIs）：荟萃分析包括六项研究，共涉及 371 名 SAH 患者。与接受 SOC 治疗的患者相比，接受 FMT 治疗的患者在 1 个月和 3 个月的存活率明显更高，汇总 OR 为 2.91（95% CI：1.56-5.42，P = 0.0008）和 3.07（95% CI：1.81-5.20，P = 0.05），随访 1 年的存活率（OR：1.81，95% CI：0.44-7.46，P = 0.41）：这项荟萃分析强调了 FMT 显著提高 SAH 患者短期生存率的潜力。结论：这项荟萃分析强调了 FMT 可显著提高 SAH 患者短期生存率的潜力，但这种生存获益不会持续 6-12 个月。这些发现要求对 FMT 的长期有效性进行更多研究，并制定延长生存获益的策略。

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引用次数: 0

Gastric intestinal metaplasia regression in United States population: A retrospective longitudinal study 美国人口中的胃肠化生消退：回顾性纵向研究

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-19 DOI: 10.1002/jgh3.70005

Akram I Ahmed, Ahmed El Sabagh, Claire Caplan, Arielle Lee, Won K Cho

Background and Aim

Gastric cancer is a health concern and contributes to cancer-related deaths. Gastric intestinal metaplasia (GIM) is a premalignant lesion of gastric cancer. Currently, factors associated with GIM regression are under-investigated. This study aims to assess the rate of GIM regression and identify factors associated with it.

Methods

This study was conducted at Medstar Washington Hospital Center. We included patients who had GIM between January 2015 and December 2020. Population was divided into GIM persistence or regression. Data included demographics, esophagogastroduodenoscopy findings, Helicobacter pylori status, and laboratory results. Statistical analyses included Kaplan–Meier and Cox proportional models to explore predictors of GIM regression.

Results

Among 2375 patients, 9.1% had GIM. Notably, 85 patients had GIM regression and 132 patients had persistent GIM. African Americans constituted (75%) of the regression group and (76%) of the persistence group. Peptic ulcer disease (PUD) was noted in 12.9% of the regression group at baseline, and 5.9% at follow-up; the persistence group showed 11.4% at baseline and 5.3% at follow-up (P = 0.89). Regression analysis revealed that the presence of PUD was associated with a higher rate of regression (hazard ratio [HR] 2.46, P = 0.013). Smoking status showed lower rates of regression (HR 0.54 and 0.62, P = 0.038 and 0.169). On gastric mapping, African Americans, Hispanics, and individuals of other races/ethnicities displayed lower rates of GIM regression (HR 0.68, 0.78 and 0.69).

Conclusion

PUD was associated with a higher rate of GIM regression, while smoking showed lower regression rates. Results provide insights into factors influencing GIM regression in African American population and may inform future surveillance and treatment strategies.

背景和目的：胃癌是一种健康问题，也是导致癌症相关死亡的原因之一。胃肠化生（GIM）是胃癌的前恶性病变。目前，与 GIM 消退相关的因素尚未得到充分研究。本研究旨在评估 GIM 的消退率，并确定与之相关的因素：本研究在 Medstar 华盛顿医院中心进行。我们纳入了 2015 年 1 月至 2020 年 12 月期间的 GIM 患者。人群分为 GIM 持续或消退两类。数据包括人口统计学、食管胃十二指肠镜检查结果、幽门螺杆菌状态和实验室结果。统计分析包括 Kaplan-Meier 和 Cox 比例模型，以探索 GIM 回归的预测因素：2375名患者中，9.1%患有GIM。值得注意的是，85 名患者的 GIM 退化，132 名患者的 GIM 持续存在。非裔美国人占回归组的 75%，占持续组的 76%。基线回归组中有 12.9% 的人患有消化性溃疡病 (PUD)，随访时有 5.9% 的人患有该病；持续回归组中有 11.4% 的人患有该病，随访时有 5.3% 的人患有该病（P = 0.89）。回归分析显示，PUD 的存在与较高的回归率相关（危险比 [HR] 2.46，P = 0.013）。吸烟状况显示出较低的回归率（HR 0.54 和 0.62，P = 0.038 和 0.169）。在胃造影中，非裔美国人、西班牙裔美国人和其他种族/民族的人的 GIM 回归率较低（HR 0.68、0.78 和 0.69）：结论：PUD 与较高的 GIM 回归率相关，而吸烟的回归率较低。结论：PUD 与较高的 GIM 回归率有关，而吸烟则导致较低的回归率。研究结果有助于了解影响非裔美国人 GIM 回归的因素，并为未来的监测和治疗策略提供参考。

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引用次数: 0

Risk of bleeding after abdominal paracentesis in patients with chronic liver disease and coagulopathy: A systematic review and meta-analysis 慢性肝病和凝血功能障碍患者腹腔穿刺术后出血的风险：系统回顾和荟萃分析。

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-19 DOI: 10.1002/jgh3.70013

Jin Lin Tan, Thomas Lokan, Mohamed Asif Chinnaratha, Martin Veysey

Abdominal paracentesis is a common procedure performed for both diagnostic and therapeutic purposes in patients with chronic liver disease and ascites. This review aims to provide an overview of the current evidence on the risk of bleeding associated with abdominal paracentesis. Electronic search was performed using PubMed, MEDLINE, and Ovid EMBASE from inception to 29 October 2023. Studies were included if they examined the risk of bleeding post-abdominal paracentesis or the efficacy of interventions to reduce bleeding in patients with chronic liver disease. Random-effects model was used to calculate the pooled proportions of bleeding events following abdominal paracentesis. Heterogeneity was determined by I², τ² statistics, and P-value. Eight studies were included for review. Six studies reported incident events of post-abdominal paracentesis bleeding. Pooled proportion of bleeding events following abdominal paracentesis was 0.32% (95% CI: 0.15–0.69%). The mean values for pre-procedural INR and platelet count of patients in these studies ranged between 1.4 and 2.0, and 50 and 153 × 10⁹/L, respectively. The highest recorded INR was 8.7, and the lowest platelet count was 19 × 10⁹/L. Major bleeding after abdominal paracentesis occurred in 0–0.97% of the study cohorts. Two studies demonstrated that the use of thromboelastography (TEG) before paracentesis in patients with chronic liver disease identified those at risk of procedure-related bleeding and reduced transfusion requirements. The overall risk of major bleeding after abdominal paracentesis is low in patients with chronic liver disease and coagulopathy. TEG may be used to predict bleeding risk and guide transfusion requirements.

腹腔穿刺术是慢性肝病和腹水患者为诊断和治疗目的而进行的一种常见手术。本综述旨在概述与腹腔穿刺术相关的出血风险的现有证据。从开始到 2023 年 10 月 29 日，使用 PubMed、MEDLINE 和 Ovid EMBASE 进行了电子检索。只要研究了慢性肝病患者腹腔穿刺术后出血的风险或减少出血的干预措施的有效性，均被纳入研究。采用随机效应模型计算腹腔穿刺术后出血事件的汇总比例。异质性通过I 2、τ2统计量和P值确定。共纳入八项研究进行审查。六项研究报告了腹腔穿刺术后出血事件。腹腔穿刺术后出血事件的汇总比例为 0.32%（95% CI：0.15-0.69%）。在这些研究中，患者手术前 INR 和血小板计数的平均值分别为 1.4 至 2.0 和 50 至 153 × 109/L。INR最高记录为8.7，血小板计数最低为19×109/L。腹腔穿刺术后大出血发生率为 0-0.97%。两项研究表明，在对慢性肝病患者进行腹腔穿刺术前使用血栓弹力图（TEG）可识别有手术相关出血风险的患者，并减少输血需求。慢性肝病和凝血功能障碍患者腹腔穿刺术后大出血的总体风险较低。TEG 可用于预测出血风险并指导输血需求。

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引用次数: 0

Bibliometric analysis of the correlation between H. pylori and inflammatory bowel disease 幽门螺杆菌与炎症性肠病之间相关性的文献计量分析

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-15 DOI: 10.1002/jgh3.70014

Yantong Li, Limin Li, Wenmeng Yin, Juyi Wan, Xiaolin Zhong

Background

Helicobacter pylori (H. pylori) infection is prevalent and associated with the development of various gastric diseases. On the other hand, inflammatory bowel disease (IBD) is an immune-related intestinal disorder influenced by factors like gut microbiota imbalance, genetic predisposition, and environmental influences. Despite extensive research on the H. pylori–IBD relationship, a comprehensive bibliometric analysis in this area is lacking. Therefore, this study aims to use bibliometric methods to explore research trends, hotspots, and frontiers in H. pylori and IBD-related research, offering valuable insights for future research and clinical practice.

Methods

We retrieved relevant literature on H. pylori and IBD from the Web of Science Core Collection (WoSCC) and Scopus databases covering 2007 to 2024. We perform a comprehensive analysis within the WoSCC literature. We compare these findings with relevant results from Scopus.

Results

Research on H. pylori and IBD has remained prominent in recent years. The United States leads in output, with strong contributions from authors, institutions, and journals. China, despite being a developing country, shows rapid article growth, signaling growing research potential. Key topics include Crohn's disease, gut microbiota, H. pylori infection, and ulcerative colitis. Newer interests include health, cancer prevention, and chronic gastritis.

Conclusion

Over the past, research on H. pylori and IBD has primarily centered around epidemiology and clinical studies. The question of whether H. pylori definitively offers protective effects against IBD remains unresolved. Therefore, further investigation could explore the underlying mechanisms of their relationship or initiate long-term prospective cohort studies to gather more compelling evidence.

背景幽门螺杆菌（H. pylori）感染很普遍，与各种胃病的发生有关。另一方面，炎症性肠病（IBD）是一种与免疫有关的肠道疾病，受肠道微生物群失衡、遗传易感性和环境影响等因素的影响。尽管对幽门螺杆菌与 IBD 的关系进行了广泛的研究，但该领域仍缺乏全面的文献计量分析。因此，本研究旨在利用文献计量学方法探讨幽门螺杆菌与 IBD 相关研究的趋势、热点和前沿，为未来研究和临床实践提供有价值的见解。方法我们从 2007 年至 2024 年的 Web of Science Core Collection (WoSCC) 和 Scopus 数据库中检索了与幽门螺杆菌和 IBD 相关的文献。我们对 WoSCC 文献进行了全面分析。我们将这些结果与 Scopus 的相关结果进行了比较。结果近年来，有关幽门螺杆菌和 IBD 的研究一直很突出。美国的研究成果遥遥领先，作者、机构和期刊都做出了巨大贡献。中国虽然是一个发展中国家，但文章增长迅速，表明中国的研究潜力在不断增长。主要研究课题包括克罗恩病、肠道微生物群、幽门螺杆菌感染和溃疡性结肠炎。新的兴趣点包括健康、癌症预防和慢性胃炎。结论过去，有关幽门螺杆菌和 IBD 的研究主要集中在流行病学和临床研究方面。幽门螺杆菌是否对 IBD 有明确的保护作用这一问题仍未解决。因此，进一步的调查可以探索两者关系的内在机制，或启动长期的前瞻性队列研究，以收集更有说服力的证据。

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引用次数: 0

Comparison of liver fibrosis scores and fatty liver on computed tomography as risk factors for severity of COVID-19 肝纤维化评分和计算机断层扫描脂肪肝作为 COVID-19 严重程度风险因素的比较。

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open

Pub Date : 2024-08-08 DOI: 10.1002/jgh3.70004

Yuji Kamiya, Masahiro Shinoda, Naoki Ishii, Saki Yamamoto, Tetsuo Sekine, Miwa Morikawa, Shinichiro Ota, Mio Toyama-Kousaka, Hidenori Takahashi, Hiroaki Takei, Masaharu Shinkai

Background and Aim

Increased liver fibrosis scores (LFS), such as fibrosis-4 index (FIB-4) or non-alcoholic fatty liver disease fibrosis score (NFS), and fatty liver are known risk factors for severe coronavirus disease 2019 (COVID-19). The purpose of this study was to identify the best scores, which predict the prognosis of COVID-19.

Methods

Participants comprised consecutive Japanese COVID-19 patients admitted to our hospital between February 14, 2020, and April 14, 2021. Multivariate logistic regression analysis was performed to evaluate the relationships between LFS (FIB-4, NFS, aspartate aminotransferase-to-platelet ratio index [APRI], BARD score, and hepatic steatosis index [HSI]) or fatty liver on computed tomography (CT), and severity of COVID-19.

Results

Of the 415 patients (mean age, 59 years), 177 patients (42.7%) needed oxygen therapy, 90 patients (21.7%) worsened to severe COVID-19, and 45 patients (10.8%) died during admission. Multivariate logistic regression analysis showed that increased FIB-4 and NFS were risk factors for death, severe COVID-19, and oxygen demand; that increased BARD was a risk factor for severe COVID-19 and oxygen demand; and that increased APRI and HSI were not risk factors for any status of COVID-19. Furthermore, increased NFS or BARD and fatty liver were independent risk factors for severe COVID-19 and oxygen demand.

Conclusions

This study showed that FIB-4 and NFS were the best liver fibrosis scores that predicted worse prognosis for COVID-19, and that increased NFS or BARD and fatty liver evident on CT represented independent risk factors for severe COVID-19 and oxygen demand.

背景和目的：肝纤维化评分（LFS）增加，如肝纤维化-4指数（FIB-4）或非酒精性脂肪肝肝纤维化评分（NFS），以及脂肪肝是2019年重症冠状病毒病（COVID-19）的已知风险因素。本研究的目的是确定可预测 COVID-19 预后的最佳评分：研究对象包括 2020 年 2 月 14 日至 2021 年 4 月 14 日期间在本院住院的连续日本 COVID-19 患者。对LFS（FIB-4、NFS、天冬氨酸氨基转移酶与血小板比值指数[APRI]、BARD评分和肝脏脂肪变性指数[HSI]）或计算机断层扫描（CT）显示的脂肪肝与COVID-19严重程度之间的关系进行了多变量逻辑回归分析：在 415 名患者（平均年龄 59 岁）中，177 名患者（42.7%）需要吸氧治疗，90 名患者（21.7%）病情恶化为重度 COVID-19，45 名患者（10.8%）在入院期间死亡。多变量逻辑回归分析显示，FIB-4 和 NFS 的增加是死亡、重度 COVID-19 和需氧量的风险因素；BARD 的增加是重度 COVID-19 和需氧量的风险因素；APRI 和 HSI 的增加不是任何 COVID-19 状态的风险因素。此外，NFS或BARD和脂肪肝的增加是重度COVID-19和需氧量的独立危险因素：该研究表明，FIB-4和NFS是预测COVID-19预后较差的最佳肝纤维化评分，而CT显示的NFS或BARD增加以及脂肪肝是重度COVID-19和需氧量的独立危险因素。

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引用次数: 0