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Elafibranor:A promising therapeutic approach for liver fibrosis and gut barrier dysfunction in alcohol-associated liver disease

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World Journal of Gastroenterology 2025年第3期31卷 123-126页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei City 23561Taiwan Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan Department of biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This article discusses the recent study written by Koizumi et ***-associated liver disease(ALD)is a major cause of liver-related morbidity and mortality,which is driven by complex mechanisms,including lipid accumulation,apoptosis,and inflammatory responses exacerbated by gut barrier *** study explored the therapeutic potential of elafibranor,a dual peroxisome proliferatoractivated receptor alpha/delta *** clinical trials,elafibranor has shown promise for the treatment of other liver conditions;however,its effects on ALD remain *** authors’findings indicate that elafibranor significantly reduced liver fibrosis and enhanced gut barrier integrity in patients with *** positive effects of elafibranor are mediated through multiple *** promotes lipid metabolism,reduces oxidative stress,and inhibits inflammatory responses by restoring gut barrier ***,it improves hepatocyte function by enhancing autophagic and antioxidant capacity,and it mitigates inflammation by suppressing the lipopolysaccharide/toll-like receptor 4/nuclear factor kappa b signaling *** findings indicate that elafibranor has promising clinical *** addition,the study highlights elafibranor’s potential as a therapeutic agent for liver diseases,particularly *** article underscores the importance of understanding the mechanistic pathways underlying ALD and suggests directions for future research aimed at elucidating the benefits and limitations of elafibranor.

关键词： Elafibranor Liver fibrosis Gut barrier function Alcohol-associated liver disease Peroxisome proliferatoractivated receptor agonists

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Septic shock due to cytomegalovirus colitis associated with rituximab use:A case report

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World Journal of Virology 2025年第1期14卷 118-123页

作者： Siddharth Patel Jordan Jay Prutha Pathak Mc Anto Antony Mrudula Thiriveedi Department of internal medicine Decatur Morgan HospitalDecaturAL 35601United States Department of medicine Alabama College of Osteopathic MedicineDothanAL 36303United States Department of internal medicine North Alabama Medical CenterFlorenceAL 35630United States Department of Endocrinology Diabetes and MetabolismMedical University of South Carolina/AnMed CampusAndersonSC 29621United States

bACKGROUND Cytomegalovirus(CMV)infections can cause significant morbidity and mortality in immunocompromised *** targets dysfunctional *** rituximab(RTX)therapy can cause b-lymphocyte dysfunction,increasing CMV ***,CMV infections present with critical illness such as septic *** SUMMARY A 64-year-old African American woman presented with generalized weakness and non-bloody watery diarrhea of 4-6 weeks *** did not have nausea,vomiting or,abdominal *** had been on monthly RTX infusions for neuromyelitis *** was admitted for septic shock due to *** investigations suggested pancytopenia and serology detected significantly elevated CMV *** treatment led to disease *** This case illustrates an extremely rare case of CMV colitis associated with RTX use presenting with septic *** suspicion for rare opportunistic infections is imperative in individuals with long-term RTX use.

关键词： Cytomegalovirus colitis Rituximab use Immunocompromised status Septic shock Pancytopenia Case report

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Use of graphene nanocomposites for air disinfection in dental clinics:A game-changer in infection control

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World Journal of Clinical Cases 2025年第8期13卷 57-62页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305TaiwanChina Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561TaiwanChina Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002TaiwanChina Department of biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328TaiwanChina

This manuscript features the promising findings of a study conducted by Ju et al,who used graphene nanocomposites for air disinfection in dental *** study demonstrated that,compared with conventional filters,graphene nanocom-posites substantially improved air quality and reduced microbial *** manuscript highlights the innovative application of graphene materials,emphasizing their potential to enhance dental clinic environments by minimizing secondary *** the basis of the unique antimicrobial properties of gra-phene and the original study’s rigorous methodology,we recommend using gra-phene nanocomposites in clinical settings to control airborne infections.

关键词： Graphene nanocomposites Air disinfection Dental clinics Antimicrobial properties Secondary pollution

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Association of the glycemic background patterns and the diabetes management efficacy in poorly controlled type 2 diabetes

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World Journal of Diabetes 2025年第1期16卷 74-90页

作者： Ayşe N Erbakan Müzeyyen Arslan bahadır FatoşN Kaya büşra Güleç MiraçVural Keskinler Ümmügülsüm AktemurÇelik Özge Faydalıel banu Mesçi Aytekin Oğuz Department of internal medicine Prof Dr Suleyman Yalcin City HospitalIstanbul Medeniyet UniversityIstanbul 34722Türkiye Department of Family medicine Istanbul Medeniyet UniversityIstanbul 34722Türkiye

bACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic *** To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic *** This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 *** were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as *** analysis focused on the success rates of good glycemic control and the associated factors within each *** The study showed significant improvements in HbA1c levels in all *** most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,*** one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and *** In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored ***

关键词： Type 2 diabetes mellitus Glycated hemoglobin Glycemic control Patient-centered care Diabetes management glycemic background

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Precut sphincterotomy:A reliable salvage for difficult biliary cannulation

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World Journal of Gastroenterology 2013年第1期19卷 1-7页

作者： Ulku Saritas Yucel Ustundag Ferda Harmandar Department of internal medicine Gastroenteorology ClinicsZonguldak Karaelmeas University Hospital67600 ZonguldakTurkey

Even experienced endoscopists have 90% success in achieving deep biliary cannulation with standard methods. biliary cannulation may become difficult in 10%-15% of patients with biliary obstruction and pre- cut (access) sphincterotomy is frequently chosen as a rescue treatment in these cases. Generally, precut sphincterotomy ensures a rate of 90%-100% success- ful deep biliary cannulation. The precut technique has been performed as either a fistulotomy with a needle knife sphincterotome or as a transpapillary septotomy with a standard sphincterotome. both methods have similar efficacy and complication rates when adminis- tered to the proper patient. Although precut sphincter- otomy ensures over 90% success of biliary cannula- tion, it has been characterized as an independent risk factor for pancreatitis. The complications of the precut technique are not limited to pancreatitis. Two more important ones, bleeding and perforation, are also re- ported in some publications as being observed more commonly than during standard sphincterotomy. It is also reported that precut sphincterotomy increases morbidity when performed in patients without dilata- tion of their biliary tract. Nevertheless, precut sphinc- terotomy is a good alternative as a rescue method in the setting of a failed standard cannulation method. This paper discusses the technical details, timing, ef- ficacy and potential complications of precut sphincter- otomy.

关键词： biliary cannulation Salvage Precut sphincterotomy Needle knife Transpancreatic septotomy

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Opportunistic screening for atrial fibrillation with a single lead device in geriatric patients

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Journal of Geriatric Cardiology 2020年第3期17卷 149-154,I0008页

作者： Lennaert AR Zwart Rene WMM Jansen Jacob H Ruiter Tjeerd Germans Suat Simsek Martin EW Hemels Department of Geriatric medicine North West ClinicsWilhelminalaanAlkmaarthe Netherlands Department of Geriatric medicine Dijklander HospitalMaelsonstraatHoornthe Netherlands Department of Cardiology North West ClinicsWilhelminalaanAlkmaarthe Netherlands Department of internal medicine North West ClinicsWilhelminalaanAlkmaarthe Netherlands Department of Cardiology Rijnstate HospitalArnhemthe Netherlands Department of Cardiology Radboud University Medical CentreGeert Grooteplein ZuidNijmegenthe Netherlands

Objective To determine the diagnostic yield of repeated screening for atrial fibrillation(AF)among geriatric *** A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device(SLD)in a geriatric *** patients of 65 years old and older visiting the geriatric outpatient clinic were eligible for inclusion.A 12 lead ECG was performed,followed by measurements with the SLD during every visit to the geriatric outpatient clinic.A frailty index was based on the accumulation of deficits *** 478 patients were *** were excluded if they did not give informed consent(17 patients),had a pacemaker or implantable cardioverter defibrillator(20 patients),or had incomplete medical files(two patients).After exclusion,439 patients participated in this *** mean age was 78 years(range 65 to 100 years),54%were *** was known in 89 patients(20%),first detected on the baseline ECG in four patients(1%)and first detected with the SLD in 20 patients(5%)during follow up *** of the SLD was 90.0%,specificity 99.0%,negative predictive value 99.7%,and positive predictive value 73.5%.Most patients(82%)with AF were frail and 53%were severely *** Repeated screening in geriatric patients has a five times higher diagnostic yield than usual *** was easily combined with usual *** of the positive predictive value of 73.5%,it remains necessary to confirm AF with a 12 lead ECG or 24-h Holter monitoring.

关键词： Atrial fibrillation Frailty Geriatric patients Opportunistic screening The elderly

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Management of entecavir-resistant chronic hepatitis b with adefovir-based combination therapies

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World Journal of Gastroenterology 2015年第38期21卷 10874-10882页

作者： Hyoung Su Kim Hyung Joon Yim Myoung Kuk Jang Ji Won Park Sang Jun Suh Yeon Seok Seo Ji Hoon Kim bo Hyun Kim Sang Jong Park Sae Hwan Lee Sang Gyune Kim Young Seok Kim Jung Il Lee Jin-Woo Lee In Hee Kim Tae Yeob Kim Jin-Wook Kim Sook-Hyang Jeong Young Kul Jung Hana Park Seong Gyu Hwang Department of internal medicine Hallym University College of Medicine Department of internal medicine Korea University Ansan Hospital Department of internal medicine Korea University Medical College Department of internal medicine Bundang Jesaeng Hospital Department of internal medicine Soon Chun Hyang University College of Medicine Department of internal medicine Inha University School of Medicine Department of internal medicine Chonbuk National University Medical School Department of internal medicine Hanyang University College of Medicine Department of internal medicine Seoul National University College of Medicine Department of internal medicine Gachon University School of Medicine Department of internal medicine CHA Bundang Medical CenterCHA University

AIM: To evaluate the long-term efficacy adefovir(ADV)-based combination therapies in entecavir(ETV)-resistant chronic hepatitis b(CHb) patients. METHODS: F i fty CHb pat ient s wi t h genotypic resistance to ETV at 13 medical centers in South Korea were included for the analysis. All the patients received rescue therapy with the combination of ADV plus ETV(ADV/ETV,n = 23) or ADV plus lamivudine(LMV)(ADV/LMV,n = 27) for more than 12 mo. Patients were monitored at least every 3-4 mo during ADV-based combination therapy by clinical examination as well as biochemical and virological assessments. Hepatitis b virus(HbV) DNA levels were measured by realtime PCR and logarithmically transformed for analysis. Cumulative rates of virologic response(VR; HbV DNA by a logrank test. Multivariate logistic regression and Cox proportional hazards models were used to identify independent risk factors significantly associated with short-term and long-term VR,***: baseline median HbV DNA levels were 5.53(2.81-7.63) log10 IU/m L. The most commonly observed ETV genotypic mutation sites were rt184 and rt202. Patients were treated for a median of 27(12-45) mo. Overall,cumulative VR rates at 6,12,24,and 36 mo were 26%,36%,45%,and 68%,respectively. Patients treated with the ADV/ETV combination showed higher cumulative VR rates(35%,43%,65%,and 76%,respectively) than those with the ADV/LAM combination(18%,30%,30%,and 62%,respectively; P = 0.048). In the multivariate analysis,low baseline HbV DNA levels(bV DNA ble predictors achieved cumulative VR rates up to 90% at 36 mo. During the same period,the cumulative incidence of virologic breakthrough was as low as 6% in patients with the both favorable ***: If tenof

关键词： Adefovir Chronic hepatitis b Entecavir Lamivudine

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Advanced age and the clinical outcomes of transcatheter aortic valve implan-tation

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Journal of Geriatric Cardiology 2014年第2期11卷 163-170页

作者： Osama Alsara Ahmad Alsarah Heather Laird-Fick Department of internal medicine Michigan State University B-301 Clinical Center East Lansing MI 48824 USA

Aortic valve stenosis （AS） is common in the elderly. Although surgical replacement of the valve has been the gold standard of management, many patients have been excluded from surgery because they were very old, frail, or had co-morbidities that increased operative risks. In the last decade, transcatheter aortic valve implantation （TAVI） has emerged as a new treatment option suitable for these patients. This article reviews the available literature on the role of TAVI in elderly patients with severe aortic stenosis. Published studies showed that elderly individuals who underwent TAVI experienced better in-hospital recovery, and similar short and mid-term mortality compared to those underwent surgical treatment of AS. However, long-term outcomes of TAVI in elderly patients are still unknown. The available data in the literature on the ef-fect of advanced age on clinical outcomes of TAVI are limited, but the data that are available suggest that TAVI is a beneficial and tolerable procedure in very old patients. Some of the expected complications after TAVI are reported more in the oldest patients such as vascular in-jures. Other complications were comparable in TAVI patients regardless of their age group. However, very old patients may need closer monitoring to avoid further morbidities and mortality.

关键词： Aortic stenosis Transcatheter aortic valve implantation Surgical aortic valve replacement Geriatric

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Effect of pronase as mucolytic agent on imaging quality of magnifying endoscopy

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World Journal of Gastroenterology 2015年第8期21卷 2483-2489页

作者： Gwang Ha Kim Yu Kyung Cho Jae Myung Cha Sun-Young Lee Il-Kwun Chung Department of internal medicine Pusan National University School of Medicine Department of internal medicine The Catholic University of Korea Department of internal medicine Kyung Hee University Hospital at Gang Dong Department of internal medicine Konkuk University Medical Center Department of internal medicine Soonchunhyang University

AIM:To investigate the efficacy of premedication with pronase,a proteolytic enzyme,in improving imagequality during magnifying ***:The study was of a blinded,randomized,prospective *** were assigned to groups administered oral premedication of either pronase and simethicone(Group A)or simethicone alone(Group b).First,the gastric mucosal visibility grade(1-4)was determined during conventional endoscopy,and then a magnifying endoscopic examination was *** quality of images obtained by magnifying endoscopy at the stomach and the esophagus was scored from1 to 3,with a lower score indicating better *** endoscopist used water flushes as needed to obtain satisfactory magnifying endoscopic *** main study outcomes were the visibility scores during magnifying endoscopy and the number of water ***:A total of 144 patients were enrolled,and data from 143 patients(M:F=90:53,mean age 57.5 years)were *** visibility score was significantly higher in the stomach following premedication with pronase(73%with a score of 1 in Group A vs 49%in Group b,Pbut there was no difference in the esophagus visibility scores(67%with a score of 1in Group A vs 58%in Group b).Fewer water flushes[mean 0.7±0.9 times(range:0-3 times)in Group A vs 1.9±1.5 times(range:0-6 times)in Group b,Pb,P=0.88].The total gastric mucosal visibility score was also lower in Group A(4.9±1.5 vs 8.3±1.8in Group b,P<0.01).CONCLUSION:The addition of pronase to simethicone premedication resulted in clearer images during magnifying endoscopy and reduced the need for water flushes.

关键词： Pronase Narrow-band imaging,EndoscopyImage enhance

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Helicobacter pylori : Friend or foe?

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World Journal of Gastroenterology 2014年第27期20卷 8979-8985页

作者： Stephen David Howard Malnick Ehud Melzer Malka Attali Gabriel Duek Jacob Yahav Department of internal medicine C Kaplan Medical Center Gastroenterology Institute Kaplan Medical Center Department of internal medicine b Kaplan Medical Center Kaplan Medical Center Affiliated to the Hebrew University

Helicobacter pylori(H. pylori) is a Gram-negative spiral bacterium that is present in nearly half the world's population. It is the major cause of peptic ulcer disease and a recognized cause of gastric carcinoma. In addition, it is linked to non-ulcer dyspepsia, vitamin b12 deficiency, iron-deficient anemia and immune thrombocytopenic purpura. These conditions are indications for testing and treatment according to current guidelines. An additional indication according to the guidelines is "anyone with a fear of gastric cancer" which results in nearly every infected person being eligible for eradication treatment. There may be beneficial effects of H. pylori in humans, including protection from gastroesophageal reflux disease and esophageal adenocarcinoma. In addition, universal treatment will be extremely expensive(more than $32 billion in the United States), may expose the patients to adverse effects such as anaphylaxis and Clostridium difficile infection, as well as contributing to antibiotic resistance. There may also be an as yet uncertain effect on the fecal microbiome. There is a need for robust clinical data to assist in decision-making regarding treatment of H. pylori infection.

关键词： Helicobacter pylori Treatment Cost benefit Cancer

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