Pub Date : 2024-01-22eCollection Date: 2024-01-01DOI: 10.1093/gastro/goad077
José María Pinazo-Bandera, Jesús Aranda, Alberto Manuel García-García, Ramiro Alcántara, Aida Ortega-Alonso, Enrique Del Campo-Herrera, Encarnación Clavijo, M Dolores García-Escaño, Juan Jesús Ruiz Ruiz, Mónica Morales-Herrera, Vanesa Valle-López, Rosa Martín-Alarcón, Isabel Viciana, Juan Bautista Jiménez, Felix Fernández-García, Juan Pedro Toro-Ortiz, Elena Sánchez-Yáñez, Ismael Álvarez-Álvarez, Raúl J Andrade, Mercedes Robles-Díaz, Miren García-Cortés
Background: Since the introduction of direct-acting antivirals, thousands of chronic hepatitis C patients have been successfully treated. However, vulnerable populations have a higher prevalence of hepatitis C virus (HCV) infection and face barriers that impede their access to antivirals. We carried out an HCV microelimination program focused on vulnerable population groups in Malaga.
Methods: People in drug addiction treatment centers and homeless shelters in Malaga who participated in the program between October 2020 and October 2021 were included. After providing participants with educational information on HCV, a dry drop test (DDT) was used to collect blood for subsequent screening for HCV infection. The participants who were diagnosed with HCV infection were scheduled for comprehensive healthcare assessments, including blood tests, ultrasonography, elastography, and the prescription of antivirals, all conducted in a single hospital visit. Sustained viral response (SVR) was analysed 12 weeks after end of treatment.
Results: Of the 417 persons invited to participate, 271 (65%) agreed to participate in the program. These participants were screened for HCV infection and 28 of them were diagnosed with HCV infection (10%). These hepatitis C-infected patients had a mean age of 53 ± 9 years; 86% were males and 93% were or had been drug users. Among 23 patients with HCV infection, HCV genotype 1a predominated (74%). Medical exams showed that 19% (4/21) had advanced fibrosis (F3-4), and 5% (1/21) had portal hypertension. Finally, 23 infected patients received treatment with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir and SVR was confirmed in 22 patients (96%).
Conclusions: Drug users and homeless people have a higher prevalence of HCV infection than the general population. The microelimination program with educational activity and screening tools achieved a high participation rate, easy healthcare access, and a high rate of SVR despite the SARS-CoV-2 pandemic.
{"title":"Hepatitis C virus point-of-care microelimination approach in a vulnerable population in the South of Spain.","authors":"José María Pinazo-Bandera, Jesús Aranda, Alberto Manuel García-García, Ramiro Alcántara, Aida Ortega-Alonso, Enrique Del Campo-Herrera, Encarnación Clavijo, M Dolores García-Escaño, Juan Jesús Ruiz Ruiz, Mónica Morales-Herrera, Vanesa Valle-López, Rosa Martín-Alarcón, Isabel Viciana, Juan Bautista Jiménez, Felix Fernández-García, Juan Pedro Toro-Ortiz, Elena Sánchez-Yáñez, Ismael Álvarez-Álvarez, Raúl J Andrade, Mercedes Robles-Díaz, Miren García-Cortés","doi":"10.1093/gastro/goad077","DOIUrl":"10.1093/gastro/goad077","url":null,"abstract":"<p><strong>Background: </strong>Since the introduction of direct-acting antivirals, thousands of chronic hepatitis C patients have been successfully treated. However, vulnerable populations have a higher prevalence of hepatitis C virus (HCV) infection and face barriers that impede their access to antivirals. We carried out an HCV microelimination program focused on vulnerable population groups in Malaga.</p><p><strong>Methods: </strong>People in drug addiction treatment centers and homeless shelters in Malaga who participated in the program between October 2020 and October 2021 were included. After providing participants with educational information on HCV, a dry drop test (DDT) was used to collect blood for subsequent screening for HCV infection. The participants who were diagnosed with HCV infection were scheduled for comprehensive healthcare assessments, including blood tests, ultrasonography, elastography, and the prescription of antivirals, all conducted in a single hospital visit. Sustained viral response (SVR) was analysed 12 weeks after end of treatment.</p><p><strong>Results: </strong>Of the 417 persons invited to participate, 271 (65%) agreed to participate in the program. These participants were screened for HCV infection and 28 of them were diagnosed with HCV infection (10%). These hepatitis C-infected patients had a mean age of 53 ± 9 years; 86% were males and 93% were or had been drug users. Among 23 patients with HCV infection, HCV genotype 1a predominated (74%). Medical exams showed that 19% (4/21) had advanced fibrosis (F3-4), and 5% (1/21) had portal hypertension. Finally, 23 infected patients received treatment with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir and SVR was confirmed in 22 patients (96%).</p><p><strong>Conclusions: </strong>Drug users and homeless people have a higher prevalence of HCV infection than the general population. The microelimination program with educational activity and screening tools achieved a high participation rate, easy healthcare access, and a high rate of SVR despite the SARS-CoV-2 pandemic.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goad077"},"PeriodicalIF":3.8,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Recent studies have found that thyroid function may be associated with the occurrence and development of advanced liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). However, the majority of such research has consisted of cross-sectional studies. This retrospective cohort study aimed to investigate the effect of low-normal thyroid function on advanced liver fibrosis in MAFLD patients over a 5-year period.
Methods: This retrospective cohort study enrolled 825 outpatients and inpatients with MAFLD who attended the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between January 2011 and December 2018. Based on plasma thyroid hormone and thyroid-stimulating hormone levels, these patients were divided into two groups, namely a low-normal thyroid function group and a strict-normal thyroid function group. The fibrosis-4 score was used to assess advanced liver fibrosis. A chi-square test was conducted to compare the occurrence of advanced fibrosis between the groups.
Results: Among the 825 MAFLD patients, 117 and 708 were defined as having low-normal thyroid function and strict-normal thyroid function, respectively. Follow-up data were available for 767 patients (93.0%) during a 5-year period. Eight (7.5%) MAFLD patients with low-normal thyroid function and 26 (3.9%) with strict-normal thyroid function developed advanced liver fibrosis and the cumulative incidence was not significantly different (P =0.163). Stratification analysis showed that the lean MAFLD patients (body mass index ≤ 23 kg/m2) with low-normal thyroid function had a higher risk of advanced liver fibrosis than the lean MAFLD patients with strict-normal thyroid function (P <0.05).
Conclusion: Low-normal thyroid function is associated with advanced liver fibrosis among lean MAFLD patients.
{"title":"Association between low-normal thyroid function and advanced liver fibrosis in metabolic dysfunction-associated fatty liver disease patients: a retrospective cohort study.","authors":"Zixuan Li, Xiaoying Wu, Zebin Chen, Xiuqing Wei, Weiqing Chen","doi":"10.1093/gastro/goad076","DOIUrl":"10.1093/gastro/goad076","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have found that thyroid function may be associated with the occurrence and development of advanced liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). However, the majority of such research has consisted of cross-sectional studies. This retrospective cohort study aimed to investigate the effect of low-normal thyroid function on advanced liver fibrosis in MAFLD patients over a 5-year period.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 825 outpatients and inpatients with MAFLD who attended the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between January 2011 and December 2018. Based on plasma thyroid hormone and thyroid-stimulating hormone levels, these patients were divided into two groups, namely a low-normal thyroid function group and a strict-normal thyroid function group. The fibrosis-4 score was used to assess advanced liver fibrosis. A chi-square test was conducted to compare the occurrence of advanced fibrosis between the groups.</p><p><strong>Results: </strong>Among the 825 MAFLD patients, 117 and 708 were defined as having low-normal thyroid function and strict-normal thyroid function, respectively. Follow-up data were available for 767 patients (93.0%) during a 5-year period. Eight (7.5%) MAFLD patients with low-normal thyroid function and 26 (3.9%) with strict-normal thyroid function developed advanced liver fibrosis and the cumulative incidence was not significantly different (<i>P </i>=<i> </i>0.163). Stratification analysis showed that the lean MAFLD patients (body mass index ≤ 23 kg/m<sup>2</sup>) with low-normal thyroid function had a higher risk of advanced liver fibrosis than the lean MAFLD patients with strict-normal thyroid function (<i>P </i><<i> </i>0.05).</p><p><strong>Conclusion: </strong>Low-normal thyroid function is associated with advanced liver fibrosis among lean MAFLD patients.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goad076"},"PeriodicalIF":3.6,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Binge drinking (BD) has been associated with elevated liver enzymes, but the joint association of BD and adiposity with liver enzymes is understudied. We aimed to examine the combined association of BD and obesity with elevated liver enzymes. Methods Data were obtained from 285,600 patients in the Korean National Health check-up program during 2009–2015. Level I BD (BD I) was defined as alcohol consumption of >60 g (men) or >40 g (women) on one occasion in the previous year. High-intensity BD (HIBD) corresponded to at least two times the BD I levels. General and abdominal obesity were defined by body mass index and waist circumference. Logistic regression was used to examine the independent and joint associations of BD and obesity with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels. Relative excess risk (RERI), attributable proportion (AP), and synergy index (SI) were calculated to estimate the additive interaction effects. Results The mean age was 42.1 ± 0.03 years and 50.2% were women. Elevated ALT [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.02–1.16], AST (OR 1.16, 95% CI 1.11–1.23), and GGT (OR 1.84, 95% CI 1.05–1.94) were associated with HIBD. Higher odds of elevated ALT (OR 3.57, 95% CI 3.43–3.71), AST (OR 3.47, 95% CI 3.37–3.58), and GGT (OR 2.10, 95% CI 1.98–2.12) were observed in individuals with general obesity. A similar trend was observed for abdominal obesity. The RERI, AP, and SI for the interaction effect of BD and general obesity were 23%, 7%, and 13% for elevated AST levels, and 67%, 24%, and 58% for elevated GGT levels, respectively. Similar effects were observed for the interaction between BD and abdominal obesity. Conclusions Obesity aggravated the odds of elevated liver AST and GGT levels in HIBD.
摘要 背景 暴饮(BD)与肝酶升高有关,但暴饮和肥胖与肝酶升高的联合关系研究不足。我们旨在研究暴饮暴食和肥胖与肝酶升高的联合关系。方法 我们从 2009-2015 年期间韩国国民健康体检项目的 28.56 万名患者中获得了数据。I 级 BD(BD I)的定义是上一年的一次饮酒量大于 60 克(男性)或大于 40 克(女性)。高强度饮酒(HIBD)相当于饮酒量 I 级的至少两倍。全身肥胖和腹部肥胖以体重指数和腰围来定义。采用逻辑回归法检测 BD 和肥胖与丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST) 和γ-谷氨酰转移酶 (GGT) 水平升高之间的独立关联和联合关联。计算了相对超额风险(RERI)、可归因比例(AP)和协同指数(SI),以估计相加的交互效应。结果 平均年龄为 42.1 ± 0.03 岁,50.2% 为女性。谷丙转氨酶(ALT)[几率比(OR)1.09,95% 置信区间(CI)1.02-1.16]、谷草转氨酶(AST)(OR 1.16,95% CI 1.11-1.23)和谷草转氨酶(GGT)(OR 1.84,95% CI 1.05-1.94)升高与 HIBD 相关。在全身肥胖者中观察到更高的谷丙转氨酶(OR 3.57,95% CI 3.43-3.71)、谷草转氨酶(OR 3.47,95% CI 3.37-3.58)和谷草转氨酶(OR 2.10,95% CI 1.98-2.12)升高几率。腹部肥胖也有类似趋势。在 BD 和全身肥胖的交互效应中,AST 水平升高的 RERI、AP 和 SI 分别为 23%、7% 和 13%,GGT 水平升高的 RERI、AP 和 SI 分别为 67%、24% 和 58%。在 BD 和腹型肥胖之间的交互作用中也观察到类似的效果。结论 肥胖会增加 HIBD 患者肝脏 AST 和 GGT 水平升高的几率。
{"title":"Independent and additive effects of binge drinking and obesity on liver enzymes: a cross-sectional analysis using the Korean National Health Insurance Service data","authors":"Anthony Kityo, Sang-Ah Lee","doi":"10.1093/gastro/goad074","DOIUrl":"https://doi.org/10.1093/gastro/goad074","url":null,"abstract":"Abstract Background Binge drinking (BD) has been associated with elevated liver enzymes, but the joint association of BD and adiposity with liver enzymes is understudied. We aimed to examine the combined association of BD and obesity with elevated liver enzymes. Methods Data were obtained from 285,600 patients in the Korean National Health check-up program during 2009–2015. Level I BD (BD I) was defined as alcohol consumption of >60 g (men) or >40 g (women) on one occasion in the previous year. High-intensity BD (HIBD) corresponded to at least two times the BD I levels. General and abdominal obesity were defined by body mass index and waist circumference. Logistic regression was used to examine the independent and joint associations of BD and obesity with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels. Relative excess risk (RERI), attributable proportion (AP), and synergy index (SI) were calculated to estimate the additive interaction effects. Results The mean age was 42.1 ± 0.03 years and 50.2% were women. Elevated ALT [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.02–1.16], AST (OR 1.16, 95% CI 1.11–1.23), and GGT (OR 1.84, 95% CI 1.05–1.94) were associated with HIBD. Higher odds of elevated ALT (OR 3.57, 95% CI 3.43–3.71), AST (OR 3.47, 95% CI 3.37–3.58), and GGT (OR 2.10, 95% CI 1.98–2.12) were observed in individuals with general obesity. A similar trend was observed for abdominal obesity. The RERI, AP, and SI for the interaction effect of BD and general obesity were 23%, 7%, and 13% for elevated AST levels, and 67%, 24%, and 58% for elevated GGT levels, respectively. Similar effects were observed for the interaction between BD and abdominal obesity. Conclusions Obesity aggravated the odds of elevated liver AST and GGT levels in HIBD.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139444137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-05eCollection Date: 2024-01-01DOI: 10.1093/gastro/goad075
Jiayu Yan, Jie Yin, Dan Zhang, Chuankai Lv, Wenbo Pang, Yajun Chen
{"title":"An unusual interventional approach to treat Type 2 Abernethy malformation in children: two case reports.","authors":"Jiayu Yan, Jie Yin, Dan Zhang, Chuankai Lv, Wenbo Pang, Yajun Chen","doi":"10.1093/gastro/goad075","DOIUrl":"10.1093/gastro/goad075","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 1","pages":"goad075"},"PeriodicalIF":3.6,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qingfan Yang, Ting Zhang, Na Diao, Kang Chao, Huijun Shu, Jie Wu, Dexiu Guan, Li Wang, Xiwei Xu, Zhenghong Li, Xiang Gao
Abstract Background Exclusive enteral nutrition (EEN) therapy effectively induces remission in pediatric Crohn’s disease (CD). However, this may depend on the type of enteral formula used. Moreover, data on the efficacy of amino acid-based EEN are limited. Thus, we aimed to prospectively evaluate the efficacy of amino acid-based formulas for EEN in pediatric patients with active CD. Methods Patients with active CD aged between 6 and 17 years were recruited into this prospective study from four hospitals in China between March 2019 and December 2021. Patients received EEN for 8 weeks. Inflammatory and nutrition-associated indices were evaluated at 0, 4, and 8 weeks after treatment. Paired t-tests and Wilcoxon signed-rank tests were used to compare continuous and categorical variables before and after intervention, respectively. Results Twenty-four patients were included in the analysis. After an 8-week intervention period, the CD activity index significantly decreased (26.3 ± 12.2 vs 7.1 ± 8.3, P < 0.001). Most patients (66.7%) achieved complete clinical remission. Among the 22 patients who had ulcers and erosions diagnosed endoscopically at baseline, 10 (45.5%) achieved complete mucosal healing. The degree of thickening of the intestinal wall was significantly reduced after EEN intervention, with a transmural healing rate of 42.9%. Furthermore, the serum inflammatory markers decreased and there was a significant improvement in the nutrition-related indices (P < 0.05). There were no severe adverse effects. Conclusions Amino acid-based EEN is effective and safe for treating pediatric-onset CD. Studies with larger sample sizes and mechanistic and follow-up studies are required to further validate these findings.
摘要 背景 纯肠内营养(EEN)疗法可有效诱导小儿克罗恩病(CD)病情缓解。然而,这可能取决于所使用的肠内配方的类型。此外,基于氨基酸的 EEN 的疗效数据也很有限。因此,我们旨在前瞻性地评估基于氨基酸的配方对活动性 CD 儿童患者肠内营养素吸收的疗效。方法 在2019年3月至2021年12月期间,我们从中国的四家医院招募了6至17岁的活动性CD患者参与这项前瞻性研究。患者接受为期 8 周的 EEN 治疗。在治疗后的 0、4 和 8 周评估炎症和营养相关指数。采用配对 t 检验和 Wilcoxon 符号秩检验分别比较干预前后的连续变量和分类变量。结果 24 名患者参与了分析。经过 8 周的干预后,CD 活动指数明显下降(26.3 ± 12.2 vs 7.1 ± 8.3,P < 0.001)。大多数患者(66.7%)的临床症状完全缓解。在基线时经内镜诊断为溃疡和糜烂的 22 名患者中,10 人(45.5%)的粘膜完全愈合。EEN 干预后,肠壁增厚程度明显减轻,跨壁愈合率为 42.9%。此外,血清中的炎症指标也有所下降,营养相关指标也有明显改善(P < 0.05)。没有出现严重的不良反应。结论 以氨基酸为基础的 EEN 治疗小儿 CD 既有效又安全。为进一步验证这些研究结果,需要进行样本量更大的研究以及机理研究和随访研究。
{"title":"Amino acid-based enteral nutrition is effective for pediatric Crohn’s disease: a multicenter prospective study","authors":"Qingfan Yang, Ting Zhang, Na Diao, Kang Chao, Huijun Shu, Jie Wu, Dexiu Guan, Li Wang, Xiwei Xu, Zhenghong Li, Xiang Gao","doi":"10.1093/gastro/goad072","DOIUrl":"https://doi.org/10.1093/gastro/goad072","url":null,"abstract":"Abstract Background Exclusive enteral nutrition (EEN) therapy effectively induces remission in pediatric Crohn’s disease (CD). However, this may depend on the type of enteral formula used. Moreover, data on the efficacy of amino acid-based EEN are limited. Thus, we aimed to prospectively evaluate the efficacy of amino acid-based formulas for EEN in pediatric patients with active CD. Methods Patients with active CD aged between 6 and 17 years were recruited into this prospective study from four hospitals in China between March 2019 and December 2021. Patients received EEN for 8 weeks. Inflammatory and nutrition-associated indices were evaluated at 0, 4, and 8 weeks after treatment. Paired t-tests and Wilcoxon signed-rank tests were used to compare continuous and categorical variables before and after intervention, respectively. Results Twenty-four patients were included in the analysis. After an 8-week intervention period, the CD activity index significantly decreased (26.3 ± 12.2 vs 7.1 ± 8.3, P < 0.001). Most patients (66.7%) achieved complete clinical remission. Among the 22 patients who had ulcers and erosions diagnosed endoscopically at baseline, 10 (45.5%) achieved complete mucosal healing. The degree of thickening of the intestinal wall was significantly reduced after EEN intervention, with a transmural healing rate of 42.9%. Furthermore, the serum inflammatory markers decreased and there was a significant improvement in the nutrition-related indices (P < 0.05). There were no severe adverse effects. Conclusions Amino acid-based EEN is effective and safe for treating pediatric-onset CD. Studies with larger sample sizes and mechanistic and follow-up studies are required to further validate these findings.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"26 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-21eCollection Date: 2023-01-01DOI: 10.1093/gastro/goad069
Jiaqi Wang, Hailong Liu, Ajian Li, Huihong Jiang, Yun Pan, Xin Chen, Lu Yin, Moubin Lin
For patients with different clinical stages of rectal cancer, tailored surgery is urgently needed. Over the past 10 years, our team has conducted numerous anatomical studies and proposed the "four fasciae and three spaces" theory to guide rectal cancer surgery. Enlightened by the anatomical basis of the radical hysterectomy classification system of Querleu and Morrow, we proposed a new classification system of radical surgery for rectal cancer based on membrane anatomy. This system categorizes the surgery into four types (A-D) and incorporates corresponding subtypes based on the preservation of the autonomic nerve. Our surgical classification unifies the pelvic membrane anatomical terminology, validates the feasibility of classifying rectal cancer surgery using the theory of "four fasciae and three spaces," and lays the theoretical groundwork for the future development of unified and standardized classification of radical pelvic tumor surgery.
{"title":"A new membrane anatomy-oriented classification of radical surgery for rectal cancer.","authors":"Jiaqi Wang, Hailong Liu, Ajian Li, Huihong Jiang, Yun Pan, Xin Chen, Lu Yin, Moubin Lin","doi":"10.1093/gastro/goad069","DOIUrl":"https://doi.org/10.1093/gastro/goad069","url":null,"abstract":"<p><p>For patients with different clinical stages of rectal cancer, tailored surgery is urgently needed. Over the past 10 years, our team has conducted numerous anatomical studies and proposed the \"four fasciae and three spaces\" theory to guide rectal cancer surgery. Enlightened by the anatomical basis of the radical hysterectomy classification system of Querleu and Morrow, we proposed a new classification system of radical surgery for rectal cancer based on membrane anatomy. This system categorizes the surgery into four types (A-D) and incorporates corresponding subtypes based on the preservation of the autonomic nerve. Our surgical classification unifies the pelvic membrane anatomical terminology, validates the feasibility of classifying rectal cancer surgery using the theory of \"four fasciae and three spaces,\" and lays the theoretical groundwork for the future development of unified and standardized classification of radical pelvic tumor surgery.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"11 ","pages":"goad069"},"PeriodicalIF":3.6,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10739184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kensuke Shibata, N. Fujimori, T. Oono, Daisuke Motooka, Daisuke Okuzaki, Koh-hei Sonoda, Yoshihiro Ogawa, Sho Yamasaki
{"title":"Single-cell analysis for identification of T-cell clonotypes associated with IgG4 production of autoimmune pancreatitis","authors":"Kensuke Shibata, N. Fujimori, T. Oono, Daisuke Motooka, Daisuke Okuzaki, Koh-hei Sonoda, Yoshihiro Ogawa, Sho Yamasaki","doi":"10.1093/gastro/goad071","DOIUrl":"https://doi.org/10.1093/gastro/goad071","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"5 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-05eCollection Date: 2023-01-01DOI: 10.1093/gastro/goad070
Qiuying Chen, Hua Xiao, Lu Zhang, Jingjing You, Zhe Jin, Bin Zhang
Background: The efficacy of adjuvant chemotherapy (AC) on survival outcomes of patients with stage I gastric cancer (GC) after curative resection remains controversial. We aimed to determine whether these patients would benefit from AC.
Methods: This retrospective study included patients with pathologically confirmed stage I GC who underwent curative resection between November 2010 and December 2020. Patients were divided into AC and non-AC groups, then a 1:1 propensity score matching (PSM) analysis was performed to minimize the selection bias. Potential risk factors including age, pN stage, pT stage, lymphovascular invasion, perineural invasion, tumor size, histological type, and carcinoembryonic antigen level were used as matching covariates. The recurrence-free survival (RFS) and disease-specific survival (DSS) were compared between groups using the Kaplan-Meier method.
Results: A total of 902 consecutive patients were enrolled and 174 (19.3%) patients were treated with AC. PSM created 123 pairs of patients. Before PSM, patients receiving AC had lower 10-year RFS rates (90% vs 94.6%, P =0.035) than those who did not receive AC; the two groups had similar 10-year DSS rates (93.8% vs 95.0%, P =0.240). After PSM, there were no statistical differences in the 10-year RFS (90.9% vs 93.0%, P =0.507) or DSS rates (93.5% vs 93.6%, P =0.811) between the two groups. Similar results were found in the stage IA and IB subgroups. Moreover, these findings were not affected by AC cycles.
Conclusions: The addition of AC could not provide survival benefits for patients with stage I GC after surgery and follow-up is thus recommended. However, large-scale randomized clinical trials are required.
背景:辅助化疗(AC)对一期胃癌(GC)根治性切除后患者生存结局的影响仍有争议。方法:本回顾性研究纳入了2010年11月至2020年12月间行根治性切除的病理证实的I期胃癌患者。将患者分为交流组和非交流组,然后进行1:1倾向评分匹配(PSM)分析,以尽量减少选择偏差。潜在危险因素包括年龄、pN分期、pT分期、淋巴血管侵犯、神经周围侵犯、肿瘤大小、组织学类型和癌胚抗原水平作为匹配协变量。采用Kaplan-Meier法比较各组无复发生存期(RFS)和疾病特异性生存期(DSS)。结果:共有902例患者连续入组,174例(19.3%)患者接受AC治疗。PSM产生123对患者。在PSM之前,接受AC治疗的患者的10年RFS率低于未接受AC治疗的患者(90% vs 94.6%, P = 0.035);两组10年DSS率相似(93.8% vs 95.0%, P = 0.240)。PSM后,两组10年RFS (90.9% vs 93.0%, P = 0.507)和DSS (93.5% vs 93.6%, P = 0.811)比较,差异均无统计学意义。在IA期和IB期亚组中也发现了类似的结果。此外,这些发现不受交流周期的影响。结论:对于I期GC术后患者,添加AC不能提供生存益处,因此建议随访。然而,需要大规模的随机临床试验。
{"title":"Association between adjuvant chemotherapy and survival in stage I gastric cancer patients after curative resection.","authors":"Qiuying Chen, Hua Xiao, Lu Zhang, Jingjing You, Zhe Jin, Bin Zhang","doi":"10.1093/gastro/goad070","DOIUrl":"10.1093/gastro/goad070","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of adjuvant chemotherapy (AC) on survival outcomes of patients with stage I gastric cancer (GC) after curative resection remains controversial. We aimed to determine whether these patients would benefit from AC.</p><p><strong>Methods: </strong>This retrospective study included patients with pathologically confirmed stage I GC who underwent curative resection between November 2010 and December 2020. Patients were divided into AC and non-AC groups, then a 1:1 propensity score matching (PSM) analysis was performed to minimize the selection bias. Potential risk factors including age, pN stage, pT stage, lymphovascular invasion, perineural invasion, tumor size, histological type, and carcinoembryonic antigen level were used as matching covariates. The recurrence-free survival (RFS) and disease-specific survival (DSS) were compared between groups using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 902 consecutive patients were enrolled and 174 (19.3%) patients were treated with AC. PSM created 123 pairs of patients. Before PSM, patients receiving AC had lower 10-year RFS rates (90% vs 94.6%, <i>P </i>=<i> </i>0.035) than those who did not receive AC; the two groups had similar 10-year DSS rates (93.8% vs 95.0%, <i>P </i>=<i> </i>0.240). After PSM, there were no statistical differences in the 10-year RFS (90.9% vs 93.0%, <i>P </i>=<i> </i>0.507) or DSS rates (93.5% vs 93.6%, <i>P </i>=<i> </i>0.811) between the two groups. Similar results were found in the stage IA and IB subgroups. Moreover, these findings were not affected by AC cycles.</p><p><strong>Conclusions: </strong>The addition of AC could not provide survival benefits for patients with stage I GC after surgery and follow-up is thus recommended. However, large-scale randomized clinical trials are required.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"11 ","pages":"goad070"},"PeriodicalIF":3.6,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-05eCollection Date: 2023-01-01DOI: 10.1093/gastro/goad068
Niusha Sharifinejad, Elaheh Mahmoudi
Inflammatory bowel disease (IBD) is an immune-mediated inflammatory condition involving both the innate and adaptive immune systems. Recently, the role of intestinal fungal flora and their downstream immune pathways has been highlighted in the pathogenesis of IBD. Cytokines as primary immune mediators require a delicate balance for maintaining intestinal homeostasis. Although most cytokines have a predictable role in either amplifying or attenuating inflammation in IBD, a few cytokines have shown a dual function in the inflammatory state of the intestine. Some of these dual-faced cytokines are also involved in mucosal anti-microbial defense pathways, particularly against intestinal fungal residents. Here, we reviewed the role of these cytokines in IBD pathogenesis to achieve a better understanding of the fungal interactions in the development of IBD.
{"title":"Dual function of fungi-derived cytokines in inflammatory bowel diseases: protection or inflammation.","authors":"Niusha Sharifinejad, Elaheh Mahmoudi","doi":"10.1093/gastro/goad068","DOIUrl":"10.1093/gastro/goad068","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is an immune-mediated inflammatory condition involving both the innate and adaptive immune systems. Recently, the role of intestinal fungal flora and their downstream immune pathways has been highlighted in the pathogenesis of IBD. Cytokines as primary immune mediators require a delicate balance for maintaining intestinal homeostasis. Although most cytokines have a predictable role in either amplifying or attenuating inflammation in IBD, a few cytokines have shown a dual function in the inflammatory state of the intestine. Some of these dual-faced cytokines are also involved in mucosal anti-microbial defense pathways, particularly against intestinal fungal residents. Here, we reviewed the role of these cytokines in IBD pathogenesis to achieve a better understanding of the fungal interactions in the development of IBD.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"11 ","pages":"goad068"},"PeriodicalIF":3.6,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10697736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31eCollection Date: 2023-01-01DOI: 10.1093/gastro/goad067
Azin Kalani, Mina Alvandipour
{"title":"Ileorectal intussusception in an adult: a case report of an anal mass.","authors":"Azin Kalani, Mina Alvandipour","doi":"10.1093/gastro/goad067","DOIUrl":"10.1093/gastro/goad067","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"11 ","pages":"goad067"},"PeriodicalIF":3.6,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}