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Esophageal Perforation in Children: Experience in Kurdistan center for Gastroenterology and hepatology/Iraq

Open Journal of Gastroenterology 2014年第5期4卷 221-227页

作者： Adnan M. H. Hamawandi Aram Baram Ali A. G. Ramadhan Taha A. Karboli Abdulsalam Y. Taha Ako Anwar Department of Anasthesia Sulaimani Teaching Hospital Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Duhok Kurdistan Center for Gastroenterology and Hepatology Duhok Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Pediatrics School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Surgery School of Medicine Faculty of Medical Sciences University of Sulaimani Sulaimani Teaching Hospital Sulaymaniyah Iraq

Background: Esophageal perforation is a rare, but potentially life threatening injury. The etiology and management of this condition have changed overtime. Iatrogenic causes are increasingly recognized and management is evolving towards more conservative approaches. Objective: To review our experience in the management of esophageal perforation in pediatric patients. Patients and methods: This retrospective study was conducted in the Kurdistan center for gastroenterology and hepatology in Sulaimani city. Review of records for cases of esophageal perforation during the period from January 2006 to October 2013 was performed. Results: Ten cases were found to have esophageal perforation. The causes of esophageal perforation were complications of endoscopic dilation for esophageal stricture (n = 7), button battery ingestion (n = 2), complication of esophagoscopy for corrosive injury (n = 1). The mean age was 42 months (range, 18 - 75 months). The diagnosis was made during the procedure in 6 cases, within 12 hours in 2 cases and late in the two cases of battery ingestion. Subcutaneous emphysema and respiratory distress were the main presenting features. The location of perforation was thoracic in 9 cases and cervical in 1 case. Conservative management was successful in 7 patients and surgical closure was done in two patients. One death has been reported. Conclusion: Iatrogenic causes were the most common causes of esophageal perforation. Conservative management with interventions guided by clinical response can have a favorable outcome and may become the best initial treatment strategy in the future. Further larger scale studies are recommended to establish the best protocol for conservative management.

关键词： Dilatation Esophageal Perforation Children Conservative Management Sulaimani

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Nonsteroidal anti-inflammatory drugs before endoscopic ultrasound guided tissue acquisition to reduce the incidence of post procedural pancreatitis

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World Journal of Gastroenterology 2024年第8期30卷 811-816页

作者： Mike de Jong Foke van Delft Christine Roozen Erwin-Jan van Geenen Tanya Bisseling Peter Siersema Marco Bruno Department of Gastroenterology and hepatology Radboud University Medical CenterNijmegen 6525 GANetherlands Department of Gastroenterology and hepatology Erasmus University Medical CenterRotterdam 3015 GDNetherlands

Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst *** most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy *** it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to *** will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.

关键词： Pancreatitis Endoscopic ultrasound Tissue acquisition Nonsteroidal antiinflammatory drugs Pancreatic cancer

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Focal Nodular Hyperplasia: A Comprehensive Review with a Particular Focus on Pathogenesis and Complications

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Journal of Clinical and Translational hepatology 2024年第2期12卷 182-190页

作者： Jaimy Villavicencio Kim George Y.Wu Division of Gastroenterology-hepatology University of Connecticut Health CenterFarmingtonCTUSA

Focal nodular hyperplasia is a benign tumor of the liver that is often found incidentally with *** purpose of this review is to discuss the pathophysiology,rare complications that can occur due to these lesions,and management options.A literature review was performed on clinical trials and case reports involving focal nodular hyperplasia complications and management of these,as well as the proposed pathogenesis underlying these *** exposure to oral contraceptive pills and endogenous hormones have been thought to play a role in the development of these lesions,this has not been *** recently,they are thought to arise as a consequence of a vascular anomaly causing alterations in the expression of angiopoietin *** are rare,but previous cases have reported associated pain,rupture and compression of nearby structures(hepatic vein,stomach,biliary system).Resection of focal nodular hyperplasia is not usually ***,if there is associated pain with no other identifiable cause or presence of a large or growing lesion with risk of causing a complication,then surgical resection,radiofrequency ablation or arterial embolization should be considered.

关键词： Focal nodular hyperplasia Oral contraceptives Liver lesion

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Effects of Transjugular Intrahepatic Portosystemic Shunt on Renal and Pulmonary Function in Hepatic Decompensation with and without Hepatorenal and Hepatopulmonary Syndromes:A Review

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Journal of Clinical and Translational hepatology 2024年第9期12卷 780-791页

作者： Ahmed H.Abdelwahed Moataz Aboeldahb George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA Department of Gastroenterology and hepatology Mayo ClinicRochesterMNUSA

Cirrhosis is often characterized by decreased liver function,ranging from a compensated,typically asymptomatic phase to a decompensated phase characterized by the appearance of ascites or variceal bleeding,and ultimately hepatorenal syndrome(HRS)or hepatopulmonary syndrome(HPS).The latter two complications are associated with a poor prognosis and limited treatment *** cases of ascites or variceal bleeding resistant to medical therapy,transjugular intrahepatic portosystemic shunt(TIPS)is effective and *** blood by TIPS diverts portal blood to the systemic circulation,potentially increasing systemic blood volume and benefiting renal ***,TIPS could also divert nitric oxide to the systemic circulation,potentially worsening systemic hypotension and perfusion,which could be detrimental to renal *** evidence indicates that TIPS often improves renal function in patients with portal hypertension,with or without *** studies have shown persistently decreased renal function after ***,these data are insufficient to support a recommendation for the use of TIPS specifically for *** patients without pre-existing HPS,TIPS does not appear to significantly affect pulmonary gas *** of TIPS in HPS have been inconsistent;some studies have shown improvement,but effects were *** studies have shown a persistent decline in pulmonary function after *** evidence supports the need for large randomized controlled trials to investigate the beneficial effects of TIPS for *** pulmonary function data are less clear regarding TIPS for *** aim of the current report was to review the literature regarding the effects of TIPS on renal and pulmonary function in hepatic decompensation,with or without the development of HRS or HPS.

关键词： Cirrhosis Hepatorenal syndrome Hepatopulmonary syndrome Transjugular intrahepatic portosystemic shunt

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Efficacy of Addiction Pharmacotherapy in Alcohol Use Disorder and Their Effects on Liver Health

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Journal of Clinical and Translational hepatology 2024年第8期12卷 750-754页

作者： Jiahua Zhou Jiajing Li Qiuwei Pan brahim Ayada Department of Gastroenterology and hepatology Erasmus MC-University Medical CenterRotterdamthe Netherlands

Both alcohol-associated liver disease(ALD)and metabolic dysfunction-associated steatotic liver disease are leading contributors to chronic liver *** conditions often coexist,exacerbating disease *** ALD being a leading cause of liver transplantation,many individuals with alcohol use disorder(AUD)do not receive *** this review,we discussed the epidemiology of ALD in AUD,various treatment options for AUD,and their efficacy on liver *** critical analysis of current evidence underscores the need for integrated models involving multiple stakeholders to improve ALD management.

关键词： Alcohol use disorder Alcohol-associated liver disease Addiction pharmacotherapy Under treatment Metabolic dysfunctions Liver health Multidisciplinary clinics

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Hypomethylation of glycine dehydrogenase promoter in peripheral blood mononuclear cells is a new diagnostic marker of hepatitis B virus-associated hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 35-42页

作者： Li-Li Miao Jing-Wen Wang Hui-Hui Liu Shuai Gao Yu-Chen Fan Kai Wang Department of hepatology Qilu Hospital of Shandong UniversityJinan 250012China Experimental center Shandong University of Traditional Chinese MedicineJinan 250355China Institute of hepatology Shandong UniversityJinan 250012China

Background: Glycine dehydrogenase(GLDC) plays an important role in the initiation and proliferation of several human cancers. In this study, we aimed to detect the methylation status of GLDC promoter and its diagnostic value for hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC). Methods: We enrolled 197 patients, 111 with HBV-HCC, 51 with chronic hepatitis B(CHB), and 35 healthy controls(HCs). The methylation status of GLDC promoter in peripheral mononuclear cells(PBMCs) was identified by methylation specific polymerase chain reaction(MSP). The mRNA expression was examined using real-time quantitative polymerase chain reaction(q PCR). Results: The methylation frequency of the GLDC promoter was significantly lower in HBV-HCC patients(27.0%) compared to that in CHB patients(68.6%) and HCs(74.3%)( P < 0.001). The methylated group had lower alanine aminotransferase level( P = 0.035) and lower rates of tumor node metastasis(TNM) Ⅲ/Ⅳ( P = 0.043) and T3/T4( P = 0.026). TNM stage was identified to be an independent factor for GLDC promoter methylation. GLDC mRNA levels in CHB patients and HCs were significantly lower than those in HBV-HCC patients( P = 0.022 and P < 0.001, respectively). GLDC mRNA levels were significantly higher in HBV-HCC patients with unmethylated GLDC promoters than those with methylated GLDC promoters( P = 0.003). The diagnostic accuracy of alpha-fetoprotein(AFP) combined with GLDC promoter methylation for HBV-HCC was improved compared with that of AFP alone(AUC: 0.782 vs. 0.630, P < 0.001). In addition, GLDC promoter methylation was an independent predictor for overall survival of HBV-HCC patients( P = 0.038). Conclusions: The methylation frequency of GLDC promoter was lower in PBMCs from HBV-HCC patients than that from patients with CHB and HCs. The combination of AFP and GLDC promoter hypomethylation significantly improved the diagnostic accuracy of HBV-HCC.

关键词： Hepatocellular carcinoma Glycine dehydrogenase DNA methylation Peripheral blood mononuclear cells

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Reactivation of hepatitis B virus infection – an important aspect of multifaceted problem

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World Journal of Gastroenterology 2024年第26期30卷 3193-3197页

作者： Sergey Morozov Sergey Batskikh Department of Gastroenterology Hepatology and NutritionFederal Research Center of NutritionBiotechnology and Food SafetyMoscow 115446Russia Department of hepatology Moscow Clinical Scientific Center N.A.A.S.LoginovMoscow 111123Russia

In this editorial we comment on the article published in the recent issue of the W orld Journal of *** focus specifically on the problem of occult hepatitis B virus(HBV)infection,that is a result of previous hepatitis B(PHB)and a source for reactivation of *** prevalence of PHB is underestimated due to the lack of population testing ***,this condition not only com-plicate anticancer treatment,but may be responsible for the development of other diseases,like cancer or autoimmune *** we unveil possible mecha-nisms responsible for realization of these processes and suggest practical approa-ches for diagnosis and treatment.

关键词： Occult hepatitis B virus infection Hepatitis B virus reactivation Previous hepatitis B Cancer Autoimmune disorders

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Intestinal microecological transplantation for a patient with chronic radiation enteritis:A case report

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World Journal of Gastroenterology 2024年第19期30卷 2603-2611页

作者： Lin Wang Yan Li Yu-Jing Zhang Li-Hua Peng Department of Gastroenterology and hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of Gastroenterology and hepatology Chinese PLA Medical SchoolBeijing 100853China

BACKGROUND The gut microbiota is strongly associated with radiation-induced gut *** study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation *** SUMMARY A 64-year-old female with cervical cancer developed abdominal pain,diarrhea,and blood in the stool 1 year after *** electronic colonoscopy was performed to diagnose chronic radiation *** courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were *** patient experienced short-and long-term relief from symptoms without adverse *** 16S rRNA sequencing revealed significant differences in the intestinal flora’s composition between patient and healthy *** bacteria,such as Escherichia fergusonii and Romboutsia timonensis,were more in the *** bacteria such as Faecalibacterium prausnitzii,Fusicatenibacter saccharivorans,Ruminococcus bromii,and Bifidobacterium longum were more in the healthy *** microbiota transplantation resulted in a significant change in the patient's intestinal flora *** composition converged with the donor's flora,with an increase in core beneficial intestinal bacteria,such as Eubacterium rectale,and a decrease in pathogenic *** in the intestinal flora corresponded with the patients'alleviating clinical *** Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal *** study provides a new approach for treating patients with chronic radiation enteritis.

关键词： Chronic radiation enteritis Gut microbial transplantation Intestinal microecology Cancer Quality of life Case report

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Autoimmune gastritis studies and gastric cancer: True renaissance or bibliometric illusion

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World Journal of Gastroenterology 2024年第32期30卷 3783-3790页

作者： Vasily Isakov Department of Gastroenterology and hepatology Federal Research Center of NutritionBiotechnology and Food SafetyMoscow 115446Russia

A bibliometric analysis of studies dedicated to autoimmune gastritis(AIG)recently published demonstrated a noteworthy surge in publications over the last three *** can be explained by numerous publications from different regions of the world reporting the results of several studies that stimulated reassessment of our view of AIG as a precancerous ***-up studies and retrospective analyses showed that the risk of gastric cancer(GC)in AIG patients is much lower than expected if the patients ever being infected with Helicobacter pylori(***)were *** low prevalence of precancerous lesions,such as the incomplete type of intestinal metaplasia,may explain the low risk of GC in AIG patients because the spasmolytic polypeptide-expressing metaplasia commonly observed in AIG does not involve clonal reprogramming of the gastric gland and can be considered as an adaptive change rather than a true precancerous ***,changes in gastric secretion due to the progression of gastric atrophy during the course of AIG cause changes in the gastric microbiome,stimulating the growth of bacterial species such as streptococci,which may promote the development of precancerous lesions and ***,Streptococcus anginosus exhibited a robust proinflammatory response and induced the gastritis-atrophy-metaplasia-dysplasia sequence in mice,reproducing the wellestablished process for carcinogenesis associated with *** studies in ***-naïve patients evaluating gastric microbiome changes during the long-term course of AIG might provide an explanation for the enigmatic increase in GC incidence in the last decades in younger cohorts,which has been reported in economically developed countries.

关键词： Autoimmune gastritis Gastric cancer Type 1 neuroendocrine tumors Helicobacter pylori Streptococcus anginosus Intestinal metaplasia

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Pretreating and normalizing metabolomics data for statistical analysis

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Genes & Diseases 2024年第3期11卷 188-205页

作者： Jun Sun Yinglin Xia Division of Gastroenterology and hepatology Department of MedicineDepartment of Microbiology/ImmunologyUIC Cancer CenterUniversity of Illinois ChicagoJesse Brown VA Medical Center Chicago(537)ChicagoIL 60612USA Division of Gastroenterology and hepatology Department of MedicineUniversity of Illinois ChicagoChicagoIL 60612USA

Metabolomics as a research field and a set of techniques is to study the entire small molecules in biological *** is emerging as a powerful tool generally for pre-cision ***,integration of microbiome and metabolome has revealed the mechanism and functionality of microbiome in human health and ***,metabo-lomics data are very ***/pretreating and normalizing procedures on metabolomics data are usually required before statistical *** this review article,we comprehensively review various methods that are used to preprocess and pretreat metabolo-mics data,including MS-based data and NMR-based data preprocessing,dealing with zero and/or missing values and detecting outliers,data normalization,data centering and scaling,data *** discuss the advantages and limitations of each *** choice for a suitable preprocessing method is determined by the biological hypothesis,the characteristics of the data set,and the selected statistical data analysis *** then provide the perspective of their applications in the microbiome and metabolome research.

关键词： Data centering and scaling Data normalization Data transformation Missing values MS-Baseddata preprocessing NMRData preprocessing Outliers Preprocessing/pretreatment

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