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Trans-papillary bilio-pancreatic stenting: When how and which stent 经乳头胆胰支架植入术:何时、如何及使用何种支架
Pub Date : 2023-01-05 DOI: 10.3389/fgstr.2022.1092263
A. Cappello, R. Landi, C. Gerges, V. Cennamo, G. Costamagna, A. Tringali
Nowadays, stenting malignant biliary stenosis (extrahepatic or hilar), benign biliary stenosis, and pancreatic duct stenosis in chronic pancreatitis as well as stenting for prophylaxis of post- endoscopic retrograde cholangiopancreatography pancreatitis and for failed extraction of biliary stones or endoscopic papillectomy are the many common challenges for a bilio-pancreatic endoscopist. The purpose of this review is to provide a practical approach to bilio-pancreatic stenting indications and techniques. Having a thorough understanding of stenting indications and techniques, for a bilio-pancreatic endoscopist means being able to develop a tailored approach for each clinical scenario depending on the type of stent used. Biliary stents, in fact, vary in diameter, length, and composition, making it possible to give each patient personalized treatment.
目前,慢性胰腺炎的恶性胆道狭窄(肝外或肝门)、良性胆道狭窄和胰管狭窄的支架置入,以及内镜后逆行胰胆管造影胰腺炎的支架置入预防,胆道结石取出或内镜下乳头切除术失败的支架置入是胆道-胰腺内窥镜医师面临的许多共同挑战。本综述的目的是为胆胰支架植入术的适应证和技术提供一种实用的方法。对于胆胰内窥镜医师来说,彻底了解支架的适应症和技术意味着能够根据所使用的支架类型为每种临床情况制定量身定制的方法。事实上,胆道支架的直径、长度和组成各不相同,这使得对每位患者进行个性化治疗成为可能。
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引用次数: 0
Investigating the effects of long-term Aroclor 1260 exposure on fatty liver disease in a diet-induced obesity mouse model. 在饮食诱导的肥胖小鼠模型中,研究长期暴露于Aroclor 1260对脂肪肝疾病的影响。
Pub Date : 2023-01-01 DOI: 10.3389/fgstr.2023.1180712
Kimberly Z Head, Oluwanifemi E Bolatimi, Tyler C Gripshover, Min Tan, Yan Li, Timothy N Audam, Steven P Jones, Carolyn M Klinge, Matthew C Cave, Banrida Wahlang

Introduction: Polychlorinated biphenyls (PCBs) are persistent environmental toxicants that have been implicated in numerous health disorders including liver diseases such as non-alcoholic fatty liver disease (NAFLD). Toxicant-associated NAFLD, also known as toxicant-associated fatty liver disease (TAFLD), consists of a spectrum of disorders ranging from steatosis and steatohepatitis to fibrosis and hepatocellular carcinoma. Previously, our group demonstrated that 12-week exposure to the PCB mixture, Aroclor 1260, exacerbated steatohepatitis in high-fat diet (HFD)-fed mice; however, the longer-term effects of PCBs on TAFLD remain to be elucidated. This study aims to examine the longer-term effects of Aroclor 1260 (>30 weeks) in a diet-induced obesity model to better understand how duration of exposure can impact TAFLD.

Methods: Male C57BL/6 mice were exposed to Aroclor 1260 (20 mg/kg) or vehicle control by oral gavage at the beginning of the study period and fed either a low-fat diet (LFD) or HFD throughout the study period.

Results: Aroclor 1260 exposure (>30 weeks) led to steatohepatitis only in LFD-fed mice. Several Aroclor 1260 exposed LFD-fed mice also developed hepatocellular carcinoma (25%), which was absent in HFD-fed mice. The LFD+Aroclor1260 group also exhibited decreased hepatic Cyp7a1 expression and increased pro-fibrotic Acta2 expression. In contrast, longer term Aroclor 1260 exposure in conjunction with HFD did not exacerbate steatosis or inflammatory responses beyond those observed with HFD alone. Further, hepatic xenobiotic receptor activation by Aroclor 1260 was absent at 31 weeks post exposure, suggesting PCB redistribution to the adipose and other extra-hepatic tissues with time.

Discussion: Overall, the results demonstrated that longer-term PCB exposure worsened TAFLD outcomes independent of HFD feeding and suggests altered energy metabolism as a potential mechanism fueling PCB mediated toxicity without dietary insult. Additional research exploring mechanisms for these longer-term PCB mediated toxicity in TAFLD is warranted.

多氯联苯(PCBs)是一种持久性环境毒物,与许多健康疾病有关,包括肝脏疾病,如非酒精性脂肪性肝病(NAFLD)。毒性相关NAFLD,也被称为毒性相关脂肪性肝病(TAFLD),包括一系列疾病,从脂肪变性和脂肪性肝炎到纤维化和肝细胞癌。先前,我们的研究小组证明,暴露于多氯联苯混合物Aroclor 1260 12周后,会加重高脂肪饮食(HFD)喂养小鼠的脂肪性肝炎;然而,多氯联苯对TAFLD的长期影响仍有待阐明。本研究旨在研究Aroclor 1260在饮食诱导肥胖模型中的长期影响(>30周),以更好地了解暴露时间如何影响TAFLD。方法:雄性C57BL/6小鼠在研究开始时口服Aroclor 1260 (20 mg/kg)或对照,在整个研究期间分别饲喂低脂或高脂饮食。结果:Aroclor 1260暴露(>30周)仅在lfd喂养的小鼠中导致脂肪性肝炎。一些暴露于lfd喂养的Aroclor 1260小鼠也发生了肝细胞癌(25%),而hfd喂养的小鼠则没有这种情况。LFD+Aroclor1260组也表现出肝脏Cyp7a1表达降低和促纤维化Acta2表达增加。相比之下,长期暴露于Aroclor 1260与HFD联合使用并不会加剧脂肪变性或炎症反应。此外,暴露31周后,Aroclor 1260没有激活肝脏外源受体,这表明随着时间的推移,PCB重新分布到脂肪和其他肝外组织。讨论:总体而言,研究结果表明,长期的多氯联苯暴露会恶化TAFLD的结果,这与喂食高热量食物无关,并表明能量代谢的改变是一种潜在的机制,可以促进多氯联苯介导的毒性,而不影响饮食。进一步的研究探索这些长期的多氯联苯介导的TAFLD毒性的机制是必要的。
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引用次数: 0
Plasma, urine, and stool metabolites in response to dietary rice bran and navy bean supplementation in adults at high-risk for colorectal cancer. 大肠癌癌症高危人群对膳食米糠和海军豆补充的血浆、尿液和粪便代谢产物的反应
Pub Date : 2023-01-01 Epub Date: 2023-02-15 DOI: 10.3389/fgstr.2023.1087056
Emily B Hill, Bridget A Baxter, Brigitte Pfluger, Caroline K Slaughter, Melanie Beale, Hillary V Smith, Sophia S Stromberg, Madison Tipton, Hend Ibrahim, Sangeeta Rao, Heather Leach, Elizabeth P Ryan

Introduction: Dietary intake of whole grains and legumes and adequate physical activity (PA) have been associated with reduced colorectal cancer (CRC) risk. A single-blinded, two-arm, randomized, placebo-controlled pilot trial was implemented to evaluate the impact of a 12-week dietary intervention of rice bran + navy bean supplementation and PA education on metabolite profiles and the gut microbiome among individuals at high risk of CRC.

Methods: Adults (n=20) were randomized 1:1 to dietary intervention or control. All participants received PA education at baseline. Sixteen study foods were prepared with either heat-stabilized rice bran + navy bean powder or Fibersol®-2 as a placebo. Intervention participants consumed 30 g rice bran + 30 g navy bean powder daily; those in the control group consumed 10 g placebo daily. Non-targeted metabolite profiling was performed by UPLC-MS/MS to evaluate plasma, urine, and stool at 0, 6, and 12 weeks. Stool was also analyzed for primary and secondary bile acids (BAs) and short chain fatty acids (SCFAs) by UPLC-MS/MS and microbial community structure via 16S amplicon sequencing. Two-way ANOVA was used to compare differences between groups for metabolites, and mixed models were used to compare differences between groups for BAs, SCFAs, and alpha and beta diversity measures of microbial community structure.

Results: Across biological matrices, the intervention resulted in changes to several amino acid and lipid metabolites, compared to control. There was a 2.33-fold difference in plasma (p<0.001) and a 3.33-fold difference in urine (p=0.008) for the amino acid S-methylcysteine at 12 weeks. Fold-differences to 4-methoxyphenol sulfate in plasma and urine after 6 and 12 weeks (p<0.001) was a novel result from this combined rice bran and navy bean intervention in people. A 2.98-fold difference in plasma (p=0.002) and a 17.74-fold difference in stool (p=0.026) was observed for the lipid octadecenedioylcarnitine at 12 weeks. For stool BAs, 3-oxocholic acid was increased at 12 weeks compared to control within a subset of individuals (mean difference 16.2 ug/uL, p=0.022). No significant differences were observed between groups for stool SCFAs or microbial community structure.

Discussion: Dietary intake of rice bran + navy beans demonstrates beneficial modulation of host and gut microbial metabolism and represents a practical and affordable means of increasing adherence to national guidelines for CRC control and prevention in a high-risk population.

引言全谷物和豆类的饮食摄入和充足的体育活动(PA)与降低癌症(CRC)风险有关。实施了一项单盲、双臂、随机、安慰剂对照的试点试验,以评估米糠+海军豆补充和PA教育的12周饮食干预对CRC高危人群代谢产物谱和肠道微生物组的影响。方法将20名成年人按1:1随机分为饮食干预组或对照组。所有参与者在基线接受PA教育。16种研究食品是用热稳定米糠+海军蓝豆粉或Fibersol®-2作为安慰剂制备的。干预参与者每天食用30克米糠+30克海军蓝豆粉;对照组每天服用10g安慰剂。通过UPLC-MS/MS进行非靶向代谢产物分析,以评估0、6和12周时的血浆、尿液和粪便。还通过UPLC-MS/MS和16S扩增子测序的微生物群落结构分析了粪便中的初级和次级胆汁酸(BA)以及短链脂肪酸(SCFAs)。使用双向方差分析比较各组之间代谢物的差异,使用混合模型比较各组之间BA、SCFA以及微生物群落结构的α和β多样性测量的差异。结果与对照组相比,在整个生物基质中,干预导致几种氨基酸和脂质代谢产物发生变化。在12周时,血浆中的氨基酸S-甲基半胱氨酸的差异为2.33倍(p<0.001),尿液中的差异为3.33倍(p=0.008)。6周和12周后,血浆和尿液中4-甲氧基苯酚硫酸盐的倍数差异(p<0.001)是米糠和海军豆联合干预的一个新结果。在12周时,观察到脂质十八碳烯二酰肉碱的血浆差异为2.98倍(p=0.002),粪便差异为17.74倍(p=0.026)。对于粪便BA,在一组个体中,与对照组相比,3-氧代胆酸在12周时增加(平均差异16.2ug/uL,p=0.022)。在粪便SCFAs或微生物群落结构方面,各组之间没有观察到显著差异。讨论米糠+海军蓝豆的膳食摄入证明了对宿主和肠道微生物代谢的有益调节,并代表了在高危人群中提高对CRC控制和预防国家指南的遵守程度的一种实用且负担得起的方法。
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引用次数: 0
Differences by transplant type in stool multiplex PCR testing for acute diarrhea in post-solid organ transplantation 不同移植类型粪便多重PCR检测在实体器官移植后急性腹泻中的差异
Pub Date : 2022-12-22 DOI: 10.3389/fgstr.2022.1064187
Abhishek Verma, Ashley M. Hine, Andrew M Joelson, R. Mei, B. Lebwohl, J. Axelrad
Background Diarrhea in solid organ transplant (SOT) recipients is common, morbid, and increasingly evaluated using multiplex gastrointestinal PCR panel (GI panel) testing. We aimed to characterize differences between transplant organ types in GI panel evaluation of acute diarrhea in SOT recipients. Methods We performed a dual-center retrospective cross-sectional study of adult SOT recipients with acute diarrhea who underwent GI panel testing. Demographic, transplant, testing context, and GI panel data were collected. Patients were stratified by transplant type. The primary outcome was a positive GI panel. Results Of 300 transplant recipients (58 heart, 65 liver, 68 lung, and 109 renal), 118 had a positive GI panel. Renal transplant status correlated with more frequently positive GI panel and less frequent hospitalization. In a multivariate analysis adjusting for demographic factors, hospitalization, immunosuppression, and transplant age, renal transplantation was independently associated with a positive GI panel compared to lung transplantation (aOR 2.98, 95% CI 1.27-7.16). Older transplant age and outpatient testing were also independently associated with a positive GI panel. The GI panel result was associated with changes to antibiotic management. Conclusions In the evaluation of SOT recipients with acute diarrhea, GI panel result varies by transplant type, transplant age, and testing location and may affect subsequent antimicrobial therapy.
背景固体器官移植(SOT)受者腹泻是常见的、病态的,并且越来越多地使用多重胃肠道PCR小组(GI小组)检测进行评估。我们的目的是在SOT受者急性腹泻的胃肠道小组评估中描述移植器官类型之间的差异。方法我们对接受胃肠道小组测试的患有急性腹泻的成年SOT受试者进行了双中心回顾性横断面研究。收集人口统计学、移植、测试环境和胃肠道专家组数据。患者按移植类型进行分层。主要结果是胃肠道检查呈阳性。结果在300名移植受者(58名心脏、65名肝脏、68名肺部和109名肾脏)中,118人的胃肠道阳性。肾移植状态与更频繁的GI阳性组和更少的住院频率相关。在一项调整了人口统计学因素、住院、免疫抑制和移植年龄的多变量分析中,与肺移植相比,肾移植与胃肠道阳性组独立相关(aOR 2.98,95%CI 1.27-7.16)。年龄较大的移植年龄和门诊检测也与胃肠道阴性组独立相关。胃肠道专家组的结果与抗生素管理的变化有关。结论在评估SOT受者急性腹泻时,GI组结果因移植类型、移植年龄和检测地点而异,并可能影响后续的抗菌治疗。
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引用次数: 0
Single or double headed capsules for the investigation of suspected small bowel bleeding: Are two heads better than one 单头或双头胶囊用于调查疑似小肠出血:两个头比一个好吗
Pub Date : 2022-12-16 DOI: 10.3389/fgstr.2022.1071797
E. McCarthy, S. Sihag, C. Deane, C. Walker, S. Semenov, B. Ryan, N. Breslin, A. O’Connor, S. O’Donnell, D. McNamara
Background Capsule endoscopy is now the accepted first line investigation for suspected small bowel (SB) bleeding. Recent evidence suggests the diagnostic yield for SB pathology may be higher for tailored double headed (DH) SB capsules. Whether other forms of bidirectional capsules offer a similar advantage is less clear. Aim To compare the efficacy of single headed versus bidirectional capsules in detecting pathology in patients with suspected small bowel bleeding. Methods A single centre prospective comparison study was conducted over an 8 month period in a tertiary care hospital. Patients referred with overt or suspected SB bleeding were assigned to either SB3 Medtronic SB capsule (SH) during the initial four months or PillCam Colon 2 Medtronic capsule (DH) during the subsequent four months. Studies were analysed by trained Capsule Endoscopists and approved by our institutions capsule review board. Findings were compared between SH and DH capsules using a chi2 or t-test as appropriate. A p value of <0.05 was considered significant. Results 201 subjects were included, mean age 61.8 years, 90 (45%) male. Majority referred with occult bleeding, 153 (76%). DH and SH capsule used in 100 and 101 cases, respectively. 90% (n=181) capsules were complete and overall diagnostic yield was 57% (n=114). Diagnostic yield was similar between both groups - DH 53% (n=53), SH 60% (n=61). Positive finding in overt bleeding; SH 85% (n=22) versus DH 50% (n=11), p<0.02. SH capsules more frequently detected SB inflammation, 27 (27%) versus 9 (9%), p<0.002. More patients had another diagnosis in the DH (19) than the SH (9), p<0.04, the majority were type 1a vascular lesions, “red spots” or diminutive colonic polyps. Conclusion Single head and double head capsules perform similary in terms of diagnostic yield overall. This supports the continued use of standard small bowel capsules for investigation of the small bowel.
背景胶囊内窥镜检查是目前公认的疑似小肠出血的一线调查。最近的证据表明,定制的双头(DH)SB胶囊对SB病理的诊断率可能更高。其他形式的双向胶囊是否具有类似的优势尚不清楚。目的比较单头胶囊和双向胶囊在可疑小肠出血患者中检测病理的疗效。方法在一家三级护理医院进行为期8个月的单中心前瞻性比较研究。转诊为明显或疑似SB出血的患者在最初四个月内被分配到SB3美敦力SB胶囊(SH),或在随后四个月分配到PillCam Colon 2美敦力胶囊(DH)。研究由经过培训的胶囊内窥镜医生进行分析,并经我们机构的胶囊审查委员会批准。使用chi2或t检验(视情况而定)比较SH和DH胶囊之间的结果。p值<0.05被认为是显著的。结果201例受试者,平均年龄61.8岁,男性90例(45%)。多数为隐匿性出血,153例(76%)。DH和SH胶囊分别用于100例和101例。90%(n=181)的胶囊是完整的,总诊断率为57%(n=114)。两组的诊断率相似——DH 53%(n=53),SH 60%(n=61)。明显出血的阳性发现;SH 85%(n=22)与DH 50%(n=11),p<0.02。SH胶囊更频繁地检测到SB炎症,分别为27(27%)和9(9%),p<0.002。DH(19)中有其他诊断的患者比SH(9)中有更多,p<0.04,大多数是1a型血管病变、“红点”或小型结肠息肉。结论单头胶囊和双头胶囊在总的诊断率方面具有相似性。这支持继续使用标准小肠胶囊进行小肠研究。
{"title":"Single or double headed capsules for the investigation of suspected small bowel bleeding: Are two heads better than one","authors":"E. McCarthy, S. Sihag, C. Deane, C. Walker, S. Semenov, B. Ryan, N. Breslin, A. O’Connor, S. O’Donnell, D. McNamara","doi":"10.3389/fgstr.2022.1071797","DOIUrl":"https://doi.org/10.3389/fgstr.2022.1071797","url":null,"abstract":"Background Capsule endoscopy is now the accepted first line investigation for suspected small bowel (SB) bleeding. Recent evidence suggests the diagnostic yield for SB pathology may be higher for tailored double headed (DH) SB capsules. Whether other forms of bidirectional capsules offer a similar advantage is less clear. Aim To compare the efficacy of single headed versus bidirectional capsules in detecting pathology in patients with suspected small bowel bleeding. Methods A single centre prospective comparison study was conducted over an 8 month period in a tertiary care hospital. Patients referred with overt or suspected SB bleeding were assigned to either SB3 Medtronic SB capsule (SH) during the initial four months or PillCam Colon 2 Medtronic capsule (DH) during the subsequent four months. Studies were analysed by trained Capsule Endoscopists and approved by our institutions capsule review board. Findings were compared between SH and DH capsules using a chi2 or t-test as appropriate. A p value of <0.05 was considered significant. Results 201 subjects were included, mean age 61.8 years, 90 (45%) male. Majority referred with occult bleeding, 153 (76%). DH and SH capsule used in 100 and 101 cases, respectively. 90% (n=181) capsules were complete and overall diagnostic yield was 57% (n=114). Diagnostic yield was similar between both groups - DH 53% (n=53), SH 60% (n=61). Positive finding in overt bleeding; SH 85% (n=22) versus DH 50% (n=11), p<0.02. SH capsules more frequently detected SB inflammation, 27 (27%) versus 9 (9%), p<0.002. More patients had another diagnosis in the DH (19) than the SH (9), p<0.04, the majority were type 1a vascular lesions, “red spots” or diminutive colonic polyps. Conclusion Single head and double head capsules perform similary in terms of diagnostic yield overall. This supports the continued use of standard small bowel capsules for investigation of the small bowel.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47077476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stigmatization and resilience in inflammatory bowel disease patients at one-year follow-up 炎症性肠病患者一年随访中的污名化和恢复力
Pub Date : 2022-12-15 DOI: 10.3389/fgstr.2022.1063325
M. Lenti, G. Broglio, C. Mengoli, S. Cococcia, F. Borrelli de Andreis, M. Vernero, L. Pitotti, L. Padovini, Matteo Secco, M. Delliponti, G. Corazza, C. Klersy, A. Di Sabatino
Introduction Inflammatory bowel disease (IBD), namely ulcerative colitis and Crohn’s disease, is a chronic relapsing immune-mediated condition that may cause an impairment of social functions due to stigmatisation. Resilience instead is associated with an improvement in coping with adversities and thus may counteract the detrimental effects of stigmatisation. We herein sought to determine the fluctuation of stigmatisation and resilience in a cohort of patients with IBD at 1-year follow-up. Methods This is a prospective, monocentric study conducted in a tertiary referral centre. All patients with IBD were assessed at enrolment and at oneyear follow-up. Several clinical and demographic variables were collected. Stigmatisation was assessed through a validated Italian version of the Perceived Stigma Scale for IBD (PSS-IBD), while resilience was assessed through the 25-item Connor Davidson Resilience Scale (CD-RISC25). Also, self-efficacy (SEF) and self-esteem (SES) scales were assessed. Results In this study, 105 patients were included (46 Crohn’s disease, 59 ulcerative colitis; overall mean age 47 years ±11, M:F ratio 1:1.2). None of the 4 scales showed a statistically significant variation at one year compared to baseline (median CD-RISC25 64 at baseline vs 61 at follow-up; SEF 31 vs 30; SES 32.5 vs 32; PSS-IBD 0.45 vs 0.45). A statistically significant and inverse correlation was found between CD-RISC25 and PSS-IBD (rho -0.222, p=0.01), SEF and PSS-IBD (rho -0.219, p= 0.01), SES and PSS-IBD (-0.316, p=0.003). CD-RISC25 was found to be positively associated with inactive IBD (p=0.05). Discussion In this prospective study we have shown for the first time that stigmatisation, resilience, SEF and SEM did not change over a one-year time span, suggesting that, based on the information gathered, these characteristics may be independent from IBD severity or IBD flares. Furthermore, we found an inverse correlation of stigma with resilience, SEF and SES, suggesting an important role that these variables may have on preventing stigmatisation.
引言炎症性肠病(IBD),即溃疡性结肠炎和克罗恩病,是一种慢性复发性免疫介导的疾病,可能因污名化而导致社会功能受损。相反,韧性与应对逆境的能力提高有关,因此可能抵消污名化的不利影响。我们在本文中试图确定一年随访时IBD患者队列中污名化和恢复力的波动。方法这是一项前瞻性的单中心研究,在三级转诊中心进行。所有IBD患者均在入组和一年随访时进行评估。收集了几个临床和人口统计学变量。污名化通过经验证的意大利版IBD感知污名量表(PSS-IBD)进行评估,而恢复力通过25项康纳·戴维森恢复力量表(CD-RISC25)进行评估。此外,还评估了自我效能(SEF)和自尊(SES)量表。结果本研究中,纳入105名患者(46名克罗恩病患者,59名溃疡性结肠炎患者;总体平均年龄47岁±11岁,M:F比1:1.2)。与基线相比,4个量表在一年内均未显示出统计学上显著的变化(基线时的中位CD-RISC25 64与随访时的61;SEF 31与30;SES 32.5与32;PSS-IBD 0.45与0.45)CD-RISC25和PSS-IBD(rho-0.222,p=0.01),SEF和PSS-BD(rho-0.219,p=0.001),SES和PSS-BDD(-0.316,p=0.003)。发现CD-RISC25与非活动性IBD呈正相关(p=0.05)。在这项前瞻性研究中,我们首次表明污名化、恢复力、SEF和SEM在一年内没有变化,这表明,根据收集到的信息,这些特征可能与IBD严重程度或IBD发作无关。此外,我们发现污名化与韧性、社会经济能力和社会经济地位呈负相关,这表明这些变量可能在防止污名化方面发挥重要作用。
{"title":"Stigmatization and resilience in inflammatory bowel disease patients at one-year follow-up","authors":"M. Lenti, G. Broglio, C. Mengoli, S. Cococcia, F. Borrelli de Andreis, M. Vernero, L. Pitotti, L. Padovini, Matteo Secco, M. Delliponti, G. Corazza, C. Klersy, A. Di Sabatino","doi":"10.3389/fgstr.2022.1063325","DOIUrl":"https://doi.org/10.3389/fgstr.2022.1063325","url":null,"abstract":"Introduction Inflammatory bowel disease (IBD), namely ulcerative colitis and Crohn’s disease, is a chronic relapsing immune-mediated condition that may cause an impairment of social functions due to stigmatisation. Resilience instead is associated with an improvement in coping with adversities and thus may counteract the detrimental effects of stigmatisation. We herein sought to determine the fluctuation of stigmatisation and resilience in a cohort of patients with IBD at 1-year follow-up. Methods This is a prospective, monocentric study conducted in a tertiary referral centre. All patients with IBD were assessed at enrolment and at oneyear follow-up. Several clinical and demographic variables were collected. Stigmatisation was assessed through a validated Italian version of the Perceived Stigma Scale for IBD (PSS-IBD), while resilience was assessed through the 25-item Connor Davidson Resilience Scale (CD-RISC25). Also, self-efficacy (SEF) and self-esteem (SES) scales were assessed. Results In this study, 105 patients were included (46 Crohn’s disease, 59 ulcerative colitis; overall mean age 47 years ±11, M:F ratio 1:1.2). None of the 4 scales showed a statistically significant variation at one year compared to baseline (median CD-RISC25 64 at baseline vs 61 at follow-up; SEF 31 vs 30; SES 32.5 vs 32; PSS-IBD 0.45 vs 0.45). A statistically significant and inverse correlation was found between CD-RISC25 and PSS-IBD (rho -0.222, p=0.01), SEF and PSS-IBD (rho -0.219, p= 0.01), SES and PSS-IBD (-0.316, p=0.003). CD-RISC25 was found to be positively associated with inactive IBD (p=0.05). Discussion In this prospective study we have shown for the first time that stigmatisation, resilience, SEF and SEM did not change over a one-year time span, suggesting that, based on the information gathered, these characteristics may be independent from IBD severity or IBD flares. Furthermore, we found an inverse correlation of stigma with resilience, SEF and SES, suggesting an important role that these variables may have on preventing stigmatisation.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44249494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An update on the genetics of alcoholic liver disease 酒精性肝病遗传学研究进展
Pub Date : 2022-11-30 DOI: 10.3389/fgstr.2022.1030399
Ravi K Vishnubhotla, A. Kulkarni, Mithun Sharma, P. Rao, D. N. Reddy
Worldwide, an estimated 2 billion individuals consume alcohol, which contributes to short-term or long-term consequences on health and social life. Alcohol is the cause of approximately 1.8 million deaths per year, representing 3.2% of all deaths worldwide. Of the 2 billion individuals who consume alcohol, more than 75 million are diagnosed with alcohol-use disorder (AUD) and are at an enhanced risk of developing alcoholic liver disease (ALD). However, not all individuals who consume alcohol develop liver disease suggesting the intricate interactions of host genetics with the environment in the precipitation of the phenotype. With advances in genomic technologies, it is now possible to sequence clinically relevant genomic loci associated with a phenotype with precision and faster turnaround times. Genomic data in the form of variants may be used to predict susceptibility to a phenotype in an unaffected individual or may assist the clinician in predicting the outcomes after the onset of the disease. Both of these are crucial as the former would aid in reducing the future burden of the disease, and the latter would help identify and treat individuals at risk of severe liver disease. In the current review, we summarize the pathogenic mechanisms of ALD and discuss the variants identified to date that may aid in predicting alcohol dependence and the development of cirrhosis in individuals with AUD.
全世界估计有20亿人饮酒,这对健康和社会生活造成短期或长期后果。酒精每年造成约180万人死亡,占全球死亡总人数的3.2%。在20亿饮酒者中,超过7500万人被诊断为酒精使用障碍(AUD),并且患酒精性肝病(ALD)的风险增加。然而,并不是所有饮酒的人都会患上肝脏疾病,这表明宿主遗传与环境在表型沉淀中存在复杂的相互作用。随着基因组技术的进步,现在有可能对与表型相关的临床相关基因组位点进行精确测序,并且周转时间更快。变异形式的基因组数据可用于预测未受影响个体对表型的易感性,或可帮助临床医生预测疾病发病后的结果。这两者都至关重要,因为前者将有助于减轻疾病的未来负担,后者将有助于识别和治疗有严重肝病风险的个体。在当前的综述中,我们总结了ALD的致病机制,并讨论了迄今为止发现的可能有助于预测AUD患者酒精依赖和肝硬化发展的变异。
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引用次数: 2
Short-term effect of different time interval between self-expanding metallic stent and surgery for left-sided malignant colorectal obstruction 自膨胀金属支架与手术治疗左侧恶性结直肠梗阻不同时间间隔的近期疗效观察
Pub Date : 2022-11-16 DOI: 10.3389/fgstr.2022.1059916
Jiawei Zhang, M. Su, D. Lin, Qinghua Zhong, Jiancong Hu, Jia-xu Deng, Miwei Lv, T. Xu, Juan Li, Xue-feng Guo
Background The optimal time interval between self-expanding metallic stent (SEMS) placement and surgery in patients with left-sided malignant colorectal obstruction (LMCO) remains controversial. Intestinal obstruction and SEMS placement would lead to intestinal edema, local tumor infiltration, and fibrosis, which may have a certain impact on elective surgery. Although prolong time interval would reduce relative complications, the risk of tumor progression must be taken into account. Therefore, our study proposes whether there is a difference in short-term postoperative complication outcomes between waiting for an interval of ≤4weeks compared with an extended interval for neoadjuvant chemotherapy followed by surgery. Methods All patients who underwent SEMS placement as BTS treatment for LMCO between January 2012 and December 2021 were retrospectively identified. The primary outcomes of this study were short-term clinical postoperative complications (Clavien-Dindo grading ≥II). Results Of the 148 patients, 70.27% of patients underwent surgery ≤4 weeks of SEMS placement (Group 1) while 29.73% of patients underwent surgery >4 weeks of SEMS placement (Group 2). After SEMS placement, the patients in Group 2 received neoadjuvant chemotherapy and then elective surgery. Significant differences were observed between both groups (Group 2 vs Group 1) for postoperative complications (Clavien-Dindo grading ≥II, 2.3% vs 14.4%, p=0.040), postoperative bowel function time (p<0.001), postoperative hospital stay (p=0.028) and total hospital stay (p=0.002). Conclusions A bridging interval of >4 weeks between SEMS placement and surgery for LMCO has better short-term clinical outcome.
背景对于左侧恶性结直肠梗阻(LMCO)患者自膨胀金属支架(SEMS)置入与手术之间的最佳时间间隔仍存在争议。肠梗阻和SEMS放置会导致肠道水肿、局部肿瘤浸润、纤维化,对择期手术有一定影响。虽然延长时间间隔可以减少相对并发症,但必须考虑肿瘤进展的风险。因此,我们的研究提出,等待≤4周的间隔时间与延长间隔时间进行新辅助化疗后手术的短期并发症结局是否存在差异。方法回顾性分析2012年1月至2021年12月期间所有接受SEMS放置作为LMCO BTS治疗的患者。本研究的主要结局是短期临床术后并发症(Clavien-Dindo分级≥II)。结果148例患者中,SEMS放置≤4周的患者手术率为70.27%(第1组),SEMS放置≤4周的患者手术率为29.73%(第2组)。SEMS放置后,第2组患者接受新辅助化疗后择期手术。两组(2组与1组)在术后并发症(Clavien-Dindo分级≥II, 2.3% vs 14.4%, p=0.040)、术后肠功能时间(SEMS放置与LMCO手术之间的p4周)方面存在显著差异,短期临床结果更好。
{"title":"Short-term effect of different time interval between self-expanding metallic stent and surgery for left-sided malignant colorectal obstruction","authors":"Jiawei Zhang, M. Su, D. Lin, Qinghua Zhong, Jiancong Hu, Jia-xu Deng, Miwei Lv, T. Xu, Juan Li, Xue-feng Guo","doi":"10.3389/fgstr.2022.1059916","DOIUrl":"https://doi.org/10.3389/fgstr.2022.1059916","url":null,"abstract":"Background The optimal time interval between self-expanding metallic stent (SEMS) placement and surgery in patients with left-sided malignant colorectal obstruction (LMCO) remains controversial. Intestinal obstruction and SEMS placement would lead to intestinal edema, local tumor infiltration, and fibrosis, which may have a certain impact on elective surgery. Although prolong time interval would reduce relative complications, the risk of tumor progression must be taken into account. Therefore, our study proposes whether there is a difference in short-term postoperative complication outcomes between waiting for an interval of ≤4weeks compared with an extended interval for neoadjuvant chemotherapy followed by surgery. Methods All patients who underwent SEMS placement as BTS treatment for LMCO between January 2012 and December 2021 were retrospectively identified. The primary outcomes of this study were short-term clinical postoperative complications (Clavien-Dindo grading ≥II). Results Of the 148 patients, 70.27% of patients underwent surgery ≤4 weeks of SEMS placement (Group 1) while 29.73% of patients underwent surgery >4 weeks of SEMS placement (Group 2). After SEMS placement, the patients in Group 2 received neoadjuvant chemotherapy and then elective surgery. Significant differences were observed between both groups (Group 2 vs Group 1) for postoperative complications (Clavien-Dindo grading ≥II, 2.3% vs 14.4%, p=0.040), postoperative bowel function time (p<0.001), postoperative hospital stay (p=0.028) and total hospital stay (p=0.002). Conclusions A bridging interval of >4 weeks between SEMS placement and surgery for LMCO has better short-term clinical outcome.","PeriodicalId":73085,"journal":{"name":"Frontiers in gastroenterology (Lausanne, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41656008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review and meta-analysis of Lactobacillus acidophilus and Lactobacillus bulgaricus for the treatment of diarrhea 嗜酸乳杆菌和保加利亚乳杆菌治疗腹泻的系统评价和荟萃分析
Pub Date : 2022-11-09 DOI: 10.3389/fgstr.2022.983075
A. Carona, D. Jacobson, C. Hildebolt, Waqar-ur-Rehman Qureshi, Kevin Rowland
Background and aims Probiotics are widely used and prescribed to address a host of health issues. Despite evidence that different probiotic bacteria have differing therapeutic mechanisms of action, many probiotics are prescribed indiscriminately, with little research to support the use of specific formulations for a given ailment. Further investigation is required to assess the efficacy of one commonly prescribed probiotic formulation Lactobacillus acidophilus and Lactobacillus bulgaricus (helveticus) – for the treatment of diarrhea. This review seeks to assess whether administration of probiotics composed of L.acidophilus and L. bulgaricus (helveticus) are more effective than placebo in reducing symptoms of diarrhea. Methods A systematic search of randomized placebo-controlled trials evaluating the effectiveness of combination L. acidophilus and L. bulgaricus in the treatment of diarrhea by any cause was conducted and captured all available studies (n = 2411). After application of exclusion criteria, four studies were identified as suitable for inclusion. Separate meta-analyses were conducted for the proportion of cases with diarrhea in the placebo group and the treatment group. To assess differences in proportions between the placebo and treatment groups, a generalized linear model assessment was performed. Results Analyses revealed the overall proportion of cases with diarrhea in the treatment group, 36 participants who had diarrhea out of 91 total, was only 3.5% lower than the overall proportion in the placebo group, 44 participants who had diarrhea out of 105 total.(P = 0.508), with our considering that the 3.5 lower percentage to be of little or no clinical importance. Conclusion Existing literature suggests little or no clinical benefit of a L. acidophilus and L. bulgaricus probiotic formulation for the treatment of diarrhea, highlighting the need for more research or re-evaluation of its widespread use.
背景和目的益生菌被广泛使用和处方,以解决一系列健康问题。尽管有证据表明不同的益生菌具有不同的治疗机制,但许多益生菌都是不分青红皂白地开的,几乎没有研究支持使用特定配方治疗特定疾病。需要进一步的研究来评估一种常用益生菌制剂嗜酸乳杆菌和保加利亚乳杆菌(helveticus)治疗腹泻的疗效。本综述旨在评估由嗜酸乳杆菌和保加利亚乳杆菌组成的益生菌在减轻腹泻症状方面是否比安慰剂更有效。方法对评估嗜酸乳杆菌和保加利亚乳杆菌联合治疗任何原因腹泻的有效性的随机安慰剂对照试验进行系统检索,并获得所有可用的研究(n=2411)。在应用排除标准后,四项研究被确定为适合纳入。对安慰剂组和治疗组腹泻病例的比例进行了单独的荟萃分析。为了评估安慰剂组和治疗组之间的比例差异,进行了广义线性模型评估。结果分析显示,治疗组腹泻病例的总体比例(91名参与者中有36名腹泻)仅比安慰剂组的总体比例低3.5%,安慰剂组的总比例为105名参与者中的44名腹泻。(P=0.508),我们认为3.5的较低百分比几乎没有临床意义。结论现有文献表明,嗜酸乳杆菌和保加利亚乳杆菌益生菌制剂治疗腹泻的临床益处很小或没有,这突出表明需要对其广泛使用进行更多的研究或重新评估。
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引用次数: 0
”Sociobiome”: How do socioeconomic factors influence gut microbiota and enhance pathology susceptibility? - A mini-review “社会生物学”:社会经济因素如何影响肠道微生物群并增强病理易感性?-小型评论
Pub Date : 2022-11-07 DOI: 10.3389/fgstr.2022.1020190
J. Nobre, D. Alpuim Costa
The gut microbiota is becoming well recognized as a key determinant of health and disease. As a result, several studies have focused on causality and the predictive/prognostic value of the microbiota in a wide range of diseases. However, it is of greater importance to understand what sparks changes in the microbiota and how these alterations contribute to an increased susceptibility to disease. A few studies have already demonstrated that the gut microbiota could be modified by lifestyle, consequently leading to pathology. What if socioeconomic factors can also impact the gut microbiota composition and, thus, increase the susceptibility to disease? Perhaps, this is one of the factors that may have contributed to the increased inequalities between people with higher and lower socioeconomic status in terms of health. In this review, we aimed to understand more about this topic and the real impact of the “sociobiome.” Furthermore, we proposed measures to mitigate the impact of these factors on the gut microbiota composition.
肠道菌群被公认为是健康和疾病的关键决定因素。因此,一些研究集中在因果关系和微生物群在多种疾病中的预测/预后价值上。然而,更重要的是要了解是什么引发了微生物群的变化,以及这些变化如何导致对疾病的易感性增加。一些研究已经证明,肠道微生物群可能会因生活方式而改变,从而导致病理。如果社会经济因素也会影响肠道菌群组成,从而增加对疾病的易感性,那该怎么办?也许,这是造成社会经济地位较高和较低的人在健康方面的不平等加剧的因素之一。在这篇综述中,我们旨在了解更多关于这一主题和“社会生物群落”的真正影响。此外,我们提出了减轻这些因素对肠道微生物群组成影响的措施。
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引用次数: 3
期刊
Frontiers in gastroenterology (Lausanne, Switzerland)
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