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Practical approach to linear endoscopic ultrasound examination of the gallbladder

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World Journal of Radiology 2024年第6期16卷 184-195页

作者： Hussein Hassan Okasha Eyad Gadour Hassan Atalla Omar AbdAllah AbdEl-Hameed Reem Ezzat Ahmed Elsayed Alzamzamy Elsayed Ghoneem Rasha Ahmad Matar Zeinab Hassan Bogdan Miutescu Ayman Qawasmi Katarzyna M Pawlak Ahmed Elmeligui department of Internal medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt department of gastroenterology and hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia department of medicine School of MedicineZamzam University CollegeKhartoum 11113Sudan department of Internal medicine Hepatology and Gastroenterology UnitFaculty of MedicineMansoura UniversityMansoura 35516Egypt department of Internal medicine Faculty of MedicineAssiut UniversityAssiut 71511Egypt department of gastroenterology and Heptology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11728Egypt department of gastroenterology and Advance Endoscopy Sultant Qaboos Comprehensive Cancer Care and Research CentreMuscat 0961Oman department of Internal medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom department of gastroenterology and hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Centre in gastroenterology and hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania department of gastroenterology Al-Makassed Islamic Charitable Society HospitalCairo 11124Egypt Division of gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B 1W8Canada department of gastroenterology Southend University HospitalEssex SS26XTUnited Kingdom

The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging *** ultrasound(TUS)is typically the initial diagnostic method due to its numerous well-established ***,in cases of uncertainty or when a definitive diagnosis cannot be established,computed tomography(CT)or magnetic resonance imaging may be employed to provide more detailed ***,CT scans may sometimes offer inadequate spatial resolution,which can limit the differentiation of GB lesions,particularly when smaller yet clinically relevant abnormalities are ***,endoscopic ultrasound(EUS)provides higher frequency compared to TUS,superior spatial resolution,and the option for contrast-enhanced harmonic imaging,enabling a more comprehensive ***,EUS can serve as a supplementary tool when conventional imaging methods are *** review will describe the standard EUS examination of the GB,focusing on its endosonographic characteristics in various GB path-ologies.

关键词： Endoscopic ultrasound Linear endoscopic ultrasound Gallbladder anatomy Gallbladder pathologies Therapeutic endoscopic ultrasound

Portal hypertension in patients with nonalcoholic fatty liver disease:Current knowledge and challenges

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World Journal of gastroenterology 2024年第4期30卷 290-307页

作者： Anita Madir Ivica Grgurevic Emmanuel A Tsochatzis Massimo Pinzani department of gastroenterology Hepatology and Clinical NutritionUniversity Hospital DubravaZagreb 10000Croatia School of medicine University of ZagrebZagreb 10000Croatia faculty of Pharmacy and Biochemistry University of ZagrebZagreb 10000Croatia UCL Institute for Liver and Digestive Health Royal Free Hospital and University College LondonLondon NW32PFUnited Kingdom

Portal hypertension(PH)has traditionally been observed as a consequence of significant fibrosis and cirrhosis in advanced non-alcoholic fatty liver disease(NAFLD).However,recent studies have provided evidence that PH may develop in earlier stages of NAFLD,suggesting that there are additional pathogenetic mechanisms at work in addition to liver *** early development of PH in NAFLD is associated with hepatocellular lipid accumulation and ballooning,leading to the compression of liver *** compression and intraluminal obstacles cause mechanical forces such as strain,shear stress and elevated hydrostatic pressure that in turn activate mechanotransduction pathways,resulting in endothelial dysfunction and the development of *** spatial distribution of histological and functional changes in the periportal and perisinusoidal areas of the liver lobule are considered responsible for the pre-sinusoidal component of PH in patients with ***,current diagnostic methods such as hepatic venous pressure gradient(HVPG)measurement tend to underestimate portal pressure(PP)in NAFLD patients,who might decompensate below the HVPG threshold of 10 mmHg,which is traditionally considered the most relevant indicator of clinically significant portal hypertension(CSPH).This creates further challenges in finding a reliable diagnostic method to stratify the prognostic risk in this population of *** theory,the measurement of the portal pressure gradient guided by endoscopic ultrasound might overcome the limitations of HVPG measurement by avoiding the influence of the pre-sinusoidal component,but more investigations are needed to test its clinical utility for this *** and spleen stiffness measurement in combination with platelet count is currently the best-validated non-invasive approach for diagnosing CSPH and varices needing *** change remains the cornerstone of the treatment of PH in NAFLD,together with correcting the comp

关键词： Non-alcoholic fatty liver disease Portal hypertension Mechanotransduction Endothelial dysfunction Hepatic venous pressure gradient

Diagnostic and prognostic performances of GALAD score in staging and 1-year mortality of hepatocellular carcinoma: A prospective study

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World Journal of gastroenterology 2024年第17期30卷 2343-2353页

作者： Oraphan Jitpraphawan Witchakorn Ruamtawee Mala Treewatchareekorn Supatsri Sethasine Division of gastroenterology and hepatology Department of MedicineNavamindradhiraj UniversityDusit 10300BangkokThailand Clinical Research Center Research Facilitation DivisionNavamindradhiraj UniversityDusit 10300BangkokThailand Division of Clinical Chemistry and Immunology Navamindradhiraj UniversityDusit 10300BangkokThailand

BACKGROUND The GALAD score has improved early hepatocellular carcinoma(HCC)detection *** role of the GALAD score in staging and predicting tumor characteristics or clinical outcome of HCC remains of particular *** To determine the diagnostic/prognostic performances of the GALAD score at various phases of initial diagnosis,tumor features,and 1-year mortality of HCC and compare the performance of the GALAD score with those of other serum *** This prospective,diagnostic/prognostic study was conducted among patients with newly diagnosed HCC at the liver center of Vajira *** patients had HCC staging allocation using the Barcelona Clinic Liver Cancer(BCLC)***,HCC etiology,and HCC features were *** and the GALAD score were obtained at *** performance of the GALAD score and biomarkers were prospectively *** Exactly 115 individuals were diagnosed with *** GALAD score increased with disease *** BCLC-0/A and BCLC-B/C/D,the GALAD score predicted HCC staging with an area under the curve(AUC)of 0.868(95%CI:0.80–0.93).For identifying the curative HCC,the AUC of GALAD score was significantly higher than that of Alpha-fetoprotein(AFP)(0.753)and Lens culinaris agglutinin-reactive fraction of AFP-L3(0.706),and as good as that of Protein induced by vitamin K absence-II(PIVKA-II)(0.897).For detecting aggressive features,the GALAD score gave an AUC of 0.839(95%CI:0.75–0.92)and significantly outperformed compared to that of AFP(0.761)and AFP-L3(0.697),with a trend of superiority to that of PIVKA-II(0.772).The performance to predict 1-year mortality of GALAD score(AUC:0.711,95%CI:0.60–0.82)was better than that of AFP(0.541)and as good as that of PIVKA-II(0.736).The optimal cutoff value of GALAD score was≥6.83,with a specificity of 72.63%for exhibiting substantial reduction in the 1-year *** The GALAD model can diagnose HCC at the curative stage,includin

关键词： Alpha-fetoprotein Barcelona clinic liver cancer GALAD score Hepatocellular carcinoma Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein Protein induced by vitamin K absence-II

Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions

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World Journal of hepatology 2024年第1期16卷 17-32页

作者： Yash R Shah Hassam Ali Angad Tiwari David Guevara-Lazo Natalia Nombera-Aznaran Bhanu Siva Mohan Pinnam Manesh Kumar Gangwani Harishankar Gopakumar Amir H Sohail SriLakshmiDevi Kanumilli Ernesto Calderon-Martinez Geetha Krishnamoorthy Nimish Thakral Dushyant Singh Dahiya department of Internal medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of gastroenterology and hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States department of Internal medicine Maharani Laxmi Bai Medical CollegeJhansi 284001India faculty of medicine Universidad Peruana Cayetano HerediaLima 15102Peru department of Internal medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States department of Internal medicine The University of ToledoToledoOH 43606United States department of gastroenterology and hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States department of Surgery University of New MexicoAlbuquerqueNM 87106United States department of Internal medicine GSL Medical CollegeRajamahendravaram 533296India department of Internal medicine Universidad Nacional Autonoma de MexicoCiudad De Mexico 04510Mexico department of Digestive Diseases and Nutrition University of KentuckyLexingtonKY 40536United States Division of gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States

Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut *** prevalence of HE varies with liver disease severity and *** pathogenesis involves ammonia toxicity,gut-brain communication disruption,and *** aims to restore gut microbiota balance,addressing these ***'s efficacy has been explored in various conditions,including *** suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate *** has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver *** include improved liver function,cognitive function,and the slowing of disease ***,larger,controlled studies are needed to validate its effectiveness in these *** have shown cognitive improvements through FMT,with potential benefits in cirrhotic ***,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of *** evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor *** large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and *** FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.

关键词： Hepatic encephalopathy Fecal microbiota transplant Cognitive impairment Liver cirrhosis Chronic liver disease

Intermittent fasting and the liver: Focus on the Ramadan model

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World Journal of hepatology 2024年第8期16卷 1070-1083页

作者： Mohamed H Emara Hanan Soliman Ebada M Said Hassan Elbatae Mostafa Elazab Shady Elhefnawy Tarik I Zaher Ahmed Abdel-Razik Mohamed Elnadry department of hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversityKafr-Elshikh 33516Egypt department of medicine Alyousif HospitalAlkhobar 34622Saudi Arabia department of Tropical medicine and Infectious Diseases Tanta UniversityTanta 31512Egypt department of hepatology Gastroenterology and Infectious DiseasesBenha UniversityBenha 13511Egypt department of Tropical medicine Zagazig UniversityZagazig 44519Egypt department of Tropical medicine Mansoura UniversityMansoura 35516Egypt department of Hepato-gastroenterology and Infectious Diseases Al-Azhar UniversityCairo 11651Egypt

Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled *** duration of fasting differs from one regimen to *** fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar *** this model of fasting,observers abstain from food and water for a period that extends from dawn to *** period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the ***,longer duration of daily fasting is observed during the *** fact,RF is a peculiar type of *** is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively *** three variables of the RF model are believed to have a variable impact on different liver *** was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese *** situation is rather different for patients with liver *** was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of *** patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal *** complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to *** transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions

关键词： Intermittent fasting Ramadan fasting Non-alcoholic fatty liver disease Liver cirrhosis Peptic ulcer Liver transplantation Gilbert syndrome

Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

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World Journal of gastroenterology 2024年第28期30卷 3418-3427页

作者： Anja H W M Lemlijn-Slenter Karolina AP Wijnands Gijs van der Hamsvoort Luuk P van Iperen Nico Wolter Angelique E de Rijk Ad AM Masclee department of Social medicine Faculty of HealthMedicine and Life sciencesCare and Public Health Research Institute Maastricht UniversityMaastricht 6200 MDLimburgNetherlands Division of gastroenterology and hepatology Department of Internal MedicineSchool of Nutrition and Translational Research in MetabolismMaastricht 6200 MDLimburgNetherlands Social Medical Affairs Employee Insurance Agency(UWV)Heerlen 6400 ACLimburgNetherlands department of Research Academic Knowledge Center Work and Health South-East Netherlands(AKAG-ZON)Heerlen 6400 ACLimburgNetherlands

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of *** approach is especially relevant for patients with chronic *** gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ *** impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ *** To describe and quantify the dimensions of PH in patients with chronic GI-HPB *** Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient department of the Maastricht university Medical *** questionnaires and data from patient files were used to quantify the six dimensions of *** consistency was tested with McDonald’s ***-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered *** The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general *** quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB *** scores between the six dimensions were only very weak to weak,forcing us to quantify each domain *** All six dimensions of PH are impaired in the GI-HPB *** and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

关键词： Positive health Chronic gut disorders Gastrointestinal disorders Hepato-pancreatico-biliary disorders Integrated care

Constipation and colonoscopy

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World Journal of Gastrointestinal Endoscopy 2024年第5期16卷 244-249页

作者： Dusan Dj Popovic Branka Filipovic faculty of medicine University of BelgradeBelgrade 11000Serbia department of gastroenterology and hepatology Clinic for Internal MedicineUniversity Clinical Hospital Center“Dr.Dragisa Misovic-Dedinje”Belgrade 11000Serbia

Constipation is a significant sociomedical problem,which can be caused by various *** the diagnostic approach to patients with constipation,the following data are usually sufficient:History,complete physical examination(including rectal examination),and additional diagnostic tests.A colonoscopy is not a necessary diagnostic method for all patients with ***,if patients have alarm symptoms/signs,that suggest an organic reason for constipation,a colonoscopy is *** most important alarm symptoms/signs are age>50 years,gastrointestinal bleeding,new-onset constipation,a palpable mass in the abdomen and rectum,weight loss,anemia,inflammatory bowel disease,and family history positive for colorectal *** endoscopists do not like to deal with patients with *** are two reasons for this,namely the difficulty of endoscopy and the adequacy of *** are adversely affected by *** improve the quality of colonoscopy in these patients,good examination techniques and often more extensive preparation are *** colonoscopy technique implies adequate psychological preparation of the patient,careful insertion of the endoscope with minimal insufflation,and early detection and resolution of *** preparation for colonoscopy often requires prolonged preparation and sometimes the addition of other laxatives.

关键词： Constipation Functional constipation Colonoscopy Bowel preparation Polyethylene glycol

The History of Controlling and Treating Infectious Diseases in Ancient China

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Current Medical Science 2024年第1期44卷 64-70页

作者： Cui-ling LIU Tao ZHOU Liang-bin CHENG David FISHER Khrystyna PRONYUK Erkin MUSABAEV Yi-ping DANG Lei ZHAO department of Infectious Diseases Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China department of gastroenterology and hepatology Huanggang Hospital of Traditional Chinese MedicineHubei University of Chinese MedicineHuanggang 438000China Clinical College of Traditional Chinese medicine Hubei University of Chinese MedicineWuhan 430065China department of Liver Diseases Hubei Hospital of Traditional Chinese MedicineWuhan 430061China department of Medical Biosciences Faculty of Natural SciencesUniversity of the Western CapeBellvilleCape Town 7535South Africa department of Infectious Diseases Bogomolets National Medical UniversityKyiv 02132Ukraine The Research Institute of Virology Ministry of HealthTashkent 100122Uzbekistan department of Vascular Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

Infectious diseases are the common enemies of *** the course of historical development,they persistently threaten human health and *** today,despite the developments in medical science,we cannot escape the fear and suffering caused by infectious *** in ancient or modern times,the source of infection,route of transmission,and a susceptible population are the three key conditions for the prevalence and spread of infectious *** factors closely related to these three conditions can affect the prevalence of infectious *** is one of the cradles of world *** ancient people accumulated a great deal of experience and lessons in the long struggle against infectious *** the face of the current threat posed by widespread infectious disease,it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious *** combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights,especially for impoverished and medically underserved regions.

关键词： infectious diseases Chinese medicine public health historical review

Prevalence and risk factors associated with metabolic dysfunctionassociated steatohepatitis in patients with Helicobacter pylori infection: A population-based study

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World Journal of hepatology 2024年第10期16卷 1169-1176页

作者： Rashid Abdel-Razeq Lynn Bitar Elio R Bitar Chidera Onwuzo Mohamad-Noor Abu-Hammour Barish Eren Islam Mohamed Adejoke Johnson Antoine Boustany Somtochukwu Onwuzo Imad Asaad department of Internal medicine Cleveland Clinic FoundationClevelandOH 44111United States faculty of medicine Saint Joseph University of BeirutBeirut 11042020Lebanon faculty of medicine American University of BeirutBeirut 11072020Lebanon department of medicine&Surgery General Hospital Lagos IslandLagos Island 101223LagosNigeria department of Internal medicine Jacobi Medical Center/North Central Bronx HospitalBronxNY 10461United States Division of gastroenterology Department of Internal MedicineUniversity of Florida College of MedicineJacksonvilleFL 32209United States department of gastroenterology Allegheny General HospitalPittsburghPA 15212United States department of gastroenterology Firelands HealthSanduskyOH 44870United States

BACKGROUND Helicobacter pylori(***)is associated with the development of gastrointestinal disorders ranging from gastritis to gastric *** evidence of the association between metabolic dysfunction-associated steatohepatitis(MASH)and *** infection in the literature is ***,we aim to evaluate the risk of developing MASH in patients who have had a diagnosis of *** infection independently of any confounding *** To evaluate the risk of developing MASH in patients who have had a diagnosis of *** *** This study used a validated multicenter research database of over 360 hospitals across 26 healthcare systems across the United States from 1999 to *** regression analysis assessed the risk of developing MASH,adjusting for confounders including *** infection,obesity,type 2 diabetes,hypertension,dyslipidemia,and male gender.A two-sided P value<0.05 was considered as statistically significant,and all statistical analyses were performed using R version 4.0.2(R Foundation for Statistical Computing,Vienna,Austria,2008).RESULTS A total of 79476132 individuals were screened in the database and 69232620 were selected in the final analysis after accounting for inclusion and exclusion ***(14.30%),patients with hyperlipidemia(70.35%),hypertension(73.86%),diabetes mellitus type 2(56.46%),and obese patients(58.15%)were more common in patients with MASH compared to *** a multivariate regression analysis,the risk of MASH was increased in diabetics[odds ratio(OR):3.55;95%CI:3.48-3.62],obese(OR:5.93;95%CI:5.81-6.04),males(OR:1.49;95%CI:1.46-1.52),individuals with hyperlipidemia(OR:2.43;95%CI:2.38-2.49)and *** infection(OR:2.51;95%CI:2.31-2.73).CONCLUSION This is the largest population-based study in the United States illustrating an increased prevalence and odds of developing MASH in patients with *** infection after adjusting for risk factors.

关键词： Metabolic dysfunction-associated steatohepatitis Metabolic dysfunction-associated steatotic liver disease Helicobacter Pylori Cirrhosis Liver