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Nivolumab-induced tumour-like gastritis:A case report

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World Journal of Clinical Cases 2023年第18期11卷 4350-4359页

作者： Elena Cijauskaite Edita Kazenaite Sandra Strainiene Goda Sadauskaite Benediktas Kurlinkus Faculty of medicine Vilnius UniversityVilnius 01513Lithuania Clinic of gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 01513Lithuania Vilnius university Hospital Santaros Clinics Center of HepatologyGastroenterology and DietologyVilnius 08661Lithuania department of internal medicine and Surgery Antakalnis ClinicVilnius 10207Lithuania

BACKGROUND Immune checkpoint inhibitors are one of the modern treatment methods for advanced ***,this group of medications is also associated with various immune-related adverse events,such as colitis or *** checkpoint inhibitor-induced gastritis is a less common adverse *** SUMMARY We describe a 64-year-old woman presenting with diarrhea,nausea,and discomfort in the upper abdominal *** patient had a history of metastatic lung cancer,which was treated with *** the first endoscopy,an infiltrating gastric tumour was ***,based on endoscopic,histological and radiological findings,nivolumab-induced gastritis was *** patient was successfully treated with three courses of *** As a consequence of the increased use of immune checkpoint inhibitors,a growing number of reported immune-related adverse events could be *** diagnosis of immune checkpoint inhibitor-induced gastritis should be considered when assessing a patient treated with nivolumab with upper gastrointestinal distress.

关键词： Nivolumab Immune checkpoint inhibitors Tumour-like gastritis Proton pump inhibitors Case report

Current status of disparity in liver disease

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World Journal of hepatology 2022年第11期14卷 1940-1952页

作者： Tomoki Sempokuya Josh Warner Muaataz Azawi Akane Nogimura Linda L Wong Division of gastroenterology and hepatology Department of Internal MedicineUniversity of Nebraska Medical CenterOmahaNE 68198United States department of internal medicine University of Nebraska Medical CenterOmahaNE 68198United States Division of gastroenterology and hepatology Sanford Center for Digestive HealthSioux Falls 57105SDUruguay department of Public Health Nagoya City University Graduate School of Medical SciencesNagoya 467-8601AichiJapan Division of Psychiatry and Cognitive-Behavioral medicine Nagoya City University Graduate School of Medical SciencesNagoya 467-8601AichiJapan department of Surgery John A.Burns School of MedicineUniversity of Hawaii at ManoaHonoluluHI 96813United States

Disparities have emerged as an important issue in many aspects of healthcare in developed countries and may be based on race,ethnicity,sex,geographical location,and socioeconomic *** liver disease specifically,these potential disparities can affect access to care and outcome in viral hepatitis,chronic liver disease,and hepatocellular *** in hepatologists and medical providers versed in liver disease may amplify these disparities by compromising early detection of liver disease,surveillance for hepatocellular carcinoma,and prompt referral to subspecialists and transplant *** the United States,continued efforts have been made to address some of these disparities with better education of healthcare providers,use of telehealth to enhance access to specialists,reminders in electronic medical records,and modifying organ allocation systems for liver *** review will detail the current status of disparities in liver disease and describe current efforts to minimize these disparities.

关键词： Disparity Transplant Race Age Gender Hepatitis

Outcomes of total pancreatectomy with islet autotransplantation:A systematic review and meta-analysis

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World Journal of Transplantation 2023年第1期13卷 10-24页

作者： Shrouq Khazaaleh Sumbal Babar Mohammad Alomari Zaid Imam Pravallika Chadalavada Adalberto Jose Gonzalez Bara El Kurdi department of internal medicine Cleveland Clinic Fairview HospitalClevelandOH 44126United States department of internal medicine-Infectious Diseases Division University of Texas Health Science Center at San AntonioSan AntonioTX 78249United States department of gastroenterology and hepatology Cleveland Clinic FloridaWestonFI 33324United States department of gastroenterology and hepatology William Beaumont HospitalRoyal OakMI 48073United States department of gastroenterology and hepatology Cleveland Clinic FloridaWestonFI 33331United States department of gastroenterology and hepatology University of Texas Health Science Center at San AntonioSan AntonioTX 78249United States

BACKGROUND Despite the increased use of total pancreatectomy with islet autotransplantation(TPIAT),systematic evidence of its outcomes remains *** To evaluate the outcomes of *** We searched PubMed,EMBASE,and Cochrane databases from inception through March 2019 for studies on TPIAT *** were extracted and analyzed using comprehensive meta-analysis *** random-effects model was used for all *** was assessed using the I2 measure and Cochrane *** bias was assessed using Egger’s *** Twenty-one studies published between 1980 and 2017 examining 1011 patients were *** studies were of adults,while three studied pediatric *** independence was achieved in 53.5%[95% Confidence Interval(CI):45-62,P<0.05,I2=81%]of adults compared to 51.9%(95%CI:17-85,P<0.05,I2=84%)of *** post-procedure was achieved in 31.8%(95%CI:26-38,P<0.05,I2=64%)of adults with considerable heterogeneity compared to 47.7%(95%CI:20-77,P<0.05,I2=82%)in *** hemoglobin(HbA1C)12 mo post-surgery was reported in four studies with a pooled value of 6.76%(P=0.27).Neither stratification by age of the studied population nor metaregression analysis considering both the study publication date and the islet-cell-equivalent/kg weight explained the marked heterogeneity between *** These results indicate acceptable success for *** studies should evaluate the discussed measures before and after surgery for comparison.

关键词： Islet autotransplantation Pancreatectomy Pancreatitis Narcotics

Clinical usefulness of ursodeoxycholic acid for Japanese patients with autoimmune hepatitis

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World Journal of hepatology 2017年第1期9卷 57-63页

作者： Yuichi Torisu Masanori Nakano Keiko Takano Ryo Nakagawa Chisato Saeki Atsushi Hokari Tomohisa Ishikawa Masayuki Saruta Mikio Zeniya Division of gastroenterology and hepatology Department of Internal Medicine the Jikei University School of Medicine department of internal medicine Fuji City General Hospital department of internal medicine Sanno Medical Center

AIM To evaluate the therapeutic effects of ursodeoxycholic acid(UDCA) on autoimmune hepatitis(AIH).METHODS A total 136 patients who were diagnosed with AIH were included in our study. All of the patients underwent a liver biopsy, and had at least a probable diagnosis on the basis of either the revised scoring system or the simplified scores. Initial treatment included UDCA monotherapy(Group U, n = 48) and prednisolone(PSL) monotherapy(Group P, n = 88). Group U was further classified into two subgroups according to the effect of UDCA: Patients who had achieved remission induction with UDCA monotherapy and showed no sign of relapse(Subgroup U1, n = 34) and patients who additionally received PSL during follow-up(Subgroup U2, n = 14). We compared the clinical and histological findings between each groups, and investigated factorscontributing to the response to UDCA *** In Group U, 34 patients(71%) achieved and maintained remission over 49(range: 8-90) mo(Subgroup U1) and 14 patients(29%) additionally received PSL(Subgroup U2) during follow-up. Two patients in Subgroup U2 achieved remission induction once but additionally required PSL administration because of relapse(15 and 35 mo after the start of treatment). The remaining 12 patients in Subgroup U2 failed to achieve remission induction during follow-up, and PSL was added during 7(range: 2-18) mo. Compared with Subgroup U2, Subgroup U1 had significantly lower alanine aminotransferase(ALT) levels at onset(124 IU/L vs 262 IU/L, P = 0.023) and a significantly higher proportion of patients with mild inflammation(A1) on histological examination(70.6% vs 35.7%, P = 0.025). When multivariate analysis was performed to identify factors contributing to the response to UDCA monotherapy, only a serum ALT level of 200 IU/L or lower was found to be associated with a significant difference(P = 0.013).CONCLUSION To prevent adverse events related to corticosteroids, UDCA monotherapy for AIH needs to be considered in pat

关键词：自体免疫的肝炎日本病人不利事件 Corticosteroids Ursodeoxycholic 酸

Crohn’s disease in human immunodeficiency virus-infected patient:A case report

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World Journal of Clinical Cases 2023年第17期11卷 4202-4209页

作者： Ausra Vinikaite Benediktas Kurlinkus Dominyka Jasinskaite Sandra Strainiene Audrone Buineviciute Goda Sadauskaite Vytautas Kiudelis Edita Kazenaite Lithuanian university of Health Sciences Faculty of MedicineKaunas 44307Lithuania Clinic of gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 01513Lithuania center of hepatology Gastroenterology and DietologyVilnius University Hospital Santaros ClinicsVilnius 08661Lithuania department of internal medicine and Surgery Antakalnis ClinicVilnius 10207Lithuania department of gastroenterology Lithuanian University of Health SciencesKaunas 44307Lithuania

BACKGROUND Inflammatory bowel disease(IBD)is an autoimmune condition treated with immunosuppressive ***,the need for immune system suppression becomes questionable when infection with the human immunodeficiency virus(HIV)occurs simultaneously and impacts the course of *** reported case represents the clinical course,prescribed treatment and its effect,as well as clinical challenges faced by physicians in a combination of such *** also present a comprehensive literature review of similar *** SUMMARY A 49-year-old woman suffering from a newly diagnosed Crohn’s disease was hospitalized due to exacerbated symptoms(abdominal pain,fever,and weight loss).During her hospital stay,she tested positive for *** conservative treatment,the patient improved and was *** the outpatient clinic,her HIV infection was confirmed as stage C3,and antiretroviral treatment was initiated *** notwithstanding,soon the patient was rehospitalized with pulmonary embolism and developed a series of complications because of the subsequent coexistence of IBD and *** intensive and meticulous treatment,the patient’s condition has improved and she remains in *** The paucity of studies and data on the coexistence of HIV and IBD leaves clinicians doubting the optimal treatment options.

关键词： Crohn’s disease Inflammatory bowel disease Human immunodeficiency virus Immunocompromised patient Case report

Serological profiling of Crohn’s disease and ulcerative colitis patients reveals anti-microbial antibody signatures

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World Journal of gastroenterology 2022年第30期28卷 4089-4101页

作者： Mahasish Shome Lusheng Song Stacy Williams Yunro Chung Vel Murugan Jin G Park William Faubion Shabana F Pasha Jonathan A Leighton Joshua LaBaer Ji Qiu Virginia G.Piper center for Personalized Diagnostics Biodesign InstituteArizona State UniversityTempeAZ 85281United States department of internal medicine Mayo ClinicRochesterMN 55902United States department of internal medicine Division of Gastroenterology and HepatologyMayo Clinic ArizonaScottsdaleAZ 85259United States Division of gastroenterology Mayo Clinic School of MedicineScottsdaleAZ 85259United States

BACKGROUND The healthcare burden of inflammatory bowel disease(IBD)is rising globally and there are limited non-invasive biomarkers for accurate and early *** To understand the important role that intestinal microbiota play in IBD pathogenesis and identify anti-microbial antibody signatures that benefit clinical management of IBD *** We performed serological profiling of 100 Crohn’s disease(CD)patients,100 ulcerative colitis(UC)patients and 100 healthy controls against 1173 bacterial and 397 viral proteins from 50 bacteria and 33 viruses on protein *** study subjects were randomly divided into discovery(n=150)and validation(n=150)*** analysis was performed using R *** Anti-bacterial antibody responses showed greater differential prevalence among the three subject groups than anti-viral antibody *** identified novel antibodies against the antigens of Bacteroidetes vulgatus(BVU_0562)and Streptococcus pneumoniae(SP_1992)showing higher prevalence in CD patients relative to healthy *** also identified antibodies against the antigen of Streptococcus pyogenes(SPy_2009)showing higher prevalence in healthy controls relative to UC *** these novel antibodies,we built biomarker panels with area under the curve(AUC)of 0.81,0.87,and 0.82 distinguishing CD vs control,UC vs control,and CD vs UC,*** analysis revealed that penetrating CD behavior,colonic CD location,CD patients with a history of surgery,and extensive UC exhibited highest antibody prevalence among all *** demonstrated that autoantibodies and anti-microbial antibodies in CD patients had minimal *** We have identified antibody signatures for CD and UC using a comprehensive analysis of antimicrobial antibody response in *** antibodies and the source microorganisms of their target antigens improve our understanding of the role of specific microorganisms in IBD pathogenesis and,after f

关键词： Inflammatory bowel disease Anti-microbial antibody Protein microarray Crohn’s disease Ulcerative colitis Gut microbiome

Effects of denosumab treatment in chronic liver disease patients with osteoporosis

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World Journal of gastroenterology 2020年第33期26卷 4960-4971页

作者： Chisato Saeki Mitsuru Saito Tsunekazu Oikawa Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota Division of gastroenterology and hepatology Department of Internal MedicineThe Jikei University School of MedicineTokyo 1058461Japan department of Orthopaedic Surgery The Jikei University School of MedicineTokyo 1058461Japan Core Research Facilities Research Center for Medical ScienceThe Jikei University School of MedicineTokyo 1058461Japan

BACKGROUND Effective treatment of osteoporosis is essential for improving morbidity and health-related quality of life in chronic liver disease(CLD)*** has been shown to increase bone mineral density(BMD)and decrease the risk of osteoporotic fracture in the general ***,there are few reports evaluating the efficacy of denosumab in CLD *** To investigated the effects and safety of denosumab in CLD patients with *** Sixty CLD patients with osteoporosis were subcutaneously administered denosumab once every 6 *** study period for evaluating efficacy and safety was 12 *** from baseline in BMD at the lumbar spine,femoral neck,and total hip were evaluated at 12 mo of denosumab *** turnover and quality were assessed by measuring serum tartrate-resistant acid phosphatase-5b(bone resorption marker),serum total procollagen type I N-terminal propeptide(bone formation maker),and plasma pentosidine(bone quality marker).RESULTS Among the 405 CLD patients,138(34.1%)patients were diagnosed with osteoporosis;among these,78 patients met the exclusion criteria and thus 60 patients were finally included in the present *** median percentage changes from baseline to 12 mo of denosumab treatment in BMD at the lumbar spine,femoral neck,and total hip were+4.44%,+3.71%,and+4.03%,*** significantly improved BMD,regardless of sex,patient age,and presence of liver *** tartrate-resistant acid phosphatase-5b and procollagen type I N-terminal propeptide levels constantly and significantly declined after denosumab treatment(P<0.001).Plasma pentosidine levels were also significantly lower at 12 mo of treatment(P=0.010).No patients experienced fractures and moderate-to-severe adverse events,except for transient *** Denosumab treatment was safe and increased BMD,suppressed bone turnover,and improved bone quality marker levels in CLD patients with osteoporosis,irrespective

关键词： Chronic liver disease Denosumab Osteoporosis Bone mineral density Bone turnover Bone quality

Gut peptide changes in patients with obstructive jaundice undergoing biliary drainage:A prospective case control study

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World Journal of Clinical Cases 2022年第17期10卷 5551-5565页

作者： Tajana Pavic Stipe Pelajic Nina Blazevic Dominik Kralj Milan Milosevic Ivana Mikolasevic Ivan Lerotic Davor Hrabar department of gastroenterology and hepatology University Hospital Center Sestre MilosrdniceZagreb 10000Croatia Andrija Stampar School of Public Health WHO Collaborative Centre for Occupational Health University of ZagrebSchool of MedicineZagreb 10000Croatia department of gastroenterology University Hospital Center RijekaRijeka 51000Croatia

BACKGROUND Biliary obstruction is a relatively common condition that affects approximately 5 in 1000 people *** is very common in patients with biliary obstruction and since it is associated with significant morbidity and mortality,it is important to identify factors and mechanisms involved in its *** To determine the influence of obstructive jaundice on the hormones controlling appetite and nutritive *** This was a prospective case control study performed in a tertiary center in Zagreb,*** with biliary obstruction undergoing internal biliary drainage from September 2012 until August 2013 were *** excluding patients who developed procedure related complications or were lost in the follow-up,out of initial 73 patients,55 patients were included in the analysis,including 34 with benign and 21 with malignant ***,40 non-jaundiced controls were also ***,nutritional status,and serum ghrelin,cholecystokinin(CCK),interleukin 6(IL-6),and tumor necrosis factorα(TNF-α)were determined at admission,48 h and 28 d after internal biliary *** square test was used for categorical *** variables were analysed for normality by Kolmogorov-Smirnov test and relevant non-parametric(Mann-Whitney,Kruskal-Wallis,and Friedman)or parametric(t-test and analysis of variance)tests were *** Patients with obstructive jaundice were significantly malnourished compared to controls,regardless of disease *** ghrelin and CCK levels were significantly higher in patients with obstructive *** bilirubin concentrations were negatively correlated with ghrelin levels and positively correlated with TNF-α,but had no correlation with CCK *** internal biliary drainage,a significant improvement of nutritional status was observed although serum concentrations of ghrelin,IL-6,and TNF-α remained significantly elevated even 28 d after the *** level

关键词： Ghrelin Cholecystokinin Biliary obstruction Malnutrition

Is the iron regulatory hormone hepcidin a risk factor for alcoholic liver disease?

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World Journal of gastroenterology 2009年第10期15卷 1186-1193页

作者： Duygu Dee Harrison-Findik Division of gastroenterology and hepatology Department of Internal Medicine University of Nebraska Medical Center Omaha NE 68198-5820 United States

Despite heavy consumption over a long period of time, only a small number of alcoholics develop alcoholic liver disease. This alludes to the possibility that other factors, besides alcohol, may be involved in the progression of the disease. Over the years, many such factors have indeed been identified, including iron. Despite being crucial for various important biological processes, iron can also be harmful due to its ability to catalyze Fenton chemistry. Alcohol and iron have been shown to interact synergistically to cause liver injury. Iron-mediated cell signaling has been reported to be involved in the pathogenesis of experimental alcoholic liver disease. Hepcidin is an iron-regulatory hormone synthesized by the liver, which plays a pivotal role in iron homeostasis. Both acute and chronic alcohol exposure suppress hepcidin expression in the liver. The sera of patients with alcoholic liver disease, particularly those exhibiting higher serum iron indices, have also been reported to display reduced prohepcidin levels. Alcohol-mediated oxidative stress is involved in the inhibition of hepcidin promoter activity and transcription in the liver. This in turn leads to an increase in intestinal iron transport and liver iron storage. Hepcidin is expressed primarily in hepatocytes. It is noteworthy that both hepatocytes and Kupffer cells are involved in the progression of alcoholic liver disease. However, the activation of Kupffer cells and TNF-α signaling has been reported not to be involved in the down-regulation of hepcidin expression by alcohol in the liver. Alcohol acts within the parenchymal cells of the liver to suppress the synthesis of hepcidin. Due to its crucial role in the regulation of body iron stores, hepcidin may act as a secondary risk factor in the progression of alcoholic liver disease. The clarification of the mechanisms by which alcohol disrupts iron homeostasis will allow for further understanding of the pathogenesis of alcoholic liver disease.

关键词：酒精性肝病抗菌多肽调节激素危险因素铁介导肝脏 Kupffer细胞慢性酒精中毒