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Clinical features of gastroesophageal reflux disease and erosive esophagitis:Insights from patients undergoing esophagogastroduodenoscopy in resource-limited Ethiopia

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World Journal of Gastroenterology 2024年第34期30卷 3883-3893页

作者： Firehiwot A Mengistie Abate B Shewaye Abel T Tasamma Zekarias S Ayalew department of internal medicine Addis Ababa UniversityAddis Ababa 1176Addis AbabaEthiopia department of internal medicine Rheum Rheumatology and Internal Medicine Specialty ClinicAddis Ababa 1000Addis AbabaEthiopia Division of Gastroenterology and Hepatology Department of Internal MedicineAdera Medical and Surgical CenterAddis Ababa 1000Addis AbabaEthiopia

BACKGROUND Gastroesophageal reflux disease(GERD)is a common disease worldwide with varying clinical presentations and risk *** data for Africa is lacking,but an increasing trend is expected due to demographic and epidemiological *** endoscopic studies for general gastrointestinal disorders have shown some patients with erosive esophagitis(EE),no studies in Ethiopia have investigated the clinical characteristics,risk factors,and severity of GERD using esophagogastroduodenoscopy(EGD).AIM To assess the clinical features of GERD in Ethiopian patients who underwent EGD and determine the severity and risk factors of *** We conducted a multicenter,retrospective cross-sectional study of 221 patients diagnosed with GERD and endoscopic findings of EE at Trauma Associated Severe Hemorrhage and Amniotic Membrane Stem Cell between January 2019 and August *** were collected from electronic medical records and phone call *** used descriptive statistics and binary logistic regression analysis with SPSS version 26 to identify the association between variables with a statistical significance set at P value<*** The mean±SD age of the patients was 44.8(±15.9)years,with a male-to-female ratio of 1.6:*** most commonly reported symptom was epigastric pain(80.5%),followed by heartburn(43%).Los Angeles(LA)-A EE was diagnosed in 71.1%of patients,followed by LA-B(14.9%),LA-C(7.7%),and LA-D(5.9%).Multivariate analysis showed that age 50 or above,presence of bleeding,and endoscopic findings of duodenitis/duodenopathy were significantly associated with severe EE(P<0.05).Stricture and Barrett’s esophagus were observed in 4.5%and 1.36%of patients with EE,*** Most of the patients had milder EE with fewer ***,severe EE was more prevalent in older patients and those with duodenitis/duodenopathy.

关键词： Gastroesophageal reflux disease Erosive esophagitis Hiatal hernia Esophagogastroduodenoscopy Heart burn

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Coronary artery disease and heart failure:Late-breaking trials presented at American Heart Association scientific session 2023

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World Journal of Cardiology 2024年第7期16卷 389-396页

作者： Avilash Mondal Sashwath Srikanth Sanjana Aggarwal Naga R Alle Olufemi Odugbemi Ikechukwu Ogbu Rupak Desai department of internal medicine Nazareth HospitalPhiladelphiaPA 19152United States department of internal medicine East Carolina University GreenvilleGreenvilleNC 27834United States department of internal medicine Hamdard Institute of Medical Sciences and ResearchNew Delhi 110062India department of medicine Narayana Medical CollegeNelloreAndhra Pradesh 524003India department of internal medicine Lincoln Medical CenterBronxNY 10451United States department of internal medicine Mountainview Hospital Sunrise GMELas VegasNV 89108United States Independent Researcher AtlantaGA 30079United States

The late-breaking science presented at the 2023 scientific session of the American Heart Association paves the way for future pragmatic trials and provides meaningful information to guide management strategies in coronary artery disease and heart failure(HF).The dapagliflozin in patient with acute myocardial infarction(DAPA-MI)trial showed that dapagliflozin use among patients with acute MI without a history of diabetes mellitus or chronic HF has better cardiometabolic outcomes compared with placebo,with no difference in cardiovascular *** MINT trial showed that in patients with acute MI and anemia(Hgb<10 g/dL),a liberal transfusion goal(Hgb≥10 g/dL)was not superior to a restrictive strategy(Hgb 7-8 g/dL)with respect to 30-day all-cause death and recurrent *** ORBITA-2 trial showed that among patients with stable angina and coronary stenoses causing ischemia on little or no antianginal therapy,percutaneous coronary intervention results in greater improvements in anginal frequency and exercise times compared with a sham *** ARIES-HM3 trial showed that in patients with advanced HF who received a HeartMate 3 levitated left ventricular assist device and were anticoagulated with a vitamin K antagonist,placebo was noninferior to daily aspirin with respect to the composite endpoint of bleeding and thrombotic events at 1 *** TEAMMATE trial showed that everolimus with low-dose tacrolimus is safe in children and young adults when given≥6 months after cardiac *** patients being treated for HF with reduced ejection fraction(HFrEF)with specific out-of-pocket(OOP)costs for multiple medication options at the time of the clinical encounter may reduce‘contingency planning’and increase the extent to which patients are taking the medications decided *** primary outcome,which was cost-informed decisionmaking,defined as the clinician or patient mentioning costs of HFrEF medication,occurred in 49%of encounters with the checklist only

关键词： Heart failure Coronary artery disease Clinical trials Myocardial infarction Cardiovascular outcome Percutaneous coronary intervention Blood transfusion Cardiac transplant

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Correlations between serum kidney injury molecule-1,cystatin C and immunosuppressants:A cross-sectional study of renal transplant patients in Bahrain

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Journal of Biomedical Research 2024年第3期38卷 269-277页

作者： Kannan Sridharan Shamik Shah Mona Al Hammad Fatima Ali Mohammed Sindhan Veeramuthu Mona Abdulla Taher Mustafa Mohamed Hammad Lamees Jawad Eman Farid department of Pharmacology and Therapeutics College of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain department of Nephrology Salmaniya Medical ComplexManamaKingdom of Bahrain department of internal medicine College of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain Salmaniya medical Complex ManamaKingdom of Bahrain department of Laboratory medicine Salmaniya Medical ComplexManamaKingdom of Bahrain department of Microbiology Immunologyand Infectious DiseasesCollege of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain

Renal transplant patients receive several immunosuppressive drug regimens that are potentially nephrotoxic for *** creatinine is the standard for monitoring kidney function;however,cystatin C(Cys C)and kidney injury molecule-1(KIM-1)have been found to indicate kidney injury earlier than serum creatinine and provide a better reflection of kidney ***,we assessed Cys C and KIM-1 serum levels in renal transplant patients receiving mycophenolate mofetil,tacrolimus,sirolimus,everolimus,or cyclosporine to evaluate kidney *** used both the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)2021 equation,which is based on creatinine and combined creatinine with Cys C,and the CKD-EPI 2012 equation,which is based on Cys C alone,to estimate glomerular filtration rate(GFR).Then,we assessed the association between serum KIM-1 and GFR<90 mL per minute per 1.73 *** observed significantly higher serum Cys C levels in patients with the elevated serum creatinine,compared with those with normal serum *** estimated GFRs based on creatinine were significantly higher than those based on the other equations,while a significant positive correlation was observed among all *** KIM-1 levels were negatively correlated with the estimated GFRs by the CKD-EPI Cys C and the combined creatinine with Cys C equations.A serum KIM-1 level above 0.71 ng/mL is likely to indicate GFR<90 mL per minute per 1.73 *** observed a significant correlation between serum creatinine and Cys C in our renal transplant ***,serum KIM-1 may be used to monitor renal function when using potentially nephrotoxic drugs in renal transplants.

关键词： KIM-1 cystatin C mycophenolate mofetil tacrolimus everolimus sirolimus cyclosporine

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Addressing the alarming link between nonalcoholic fatty liver disease and cardiovascular mortality in men

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World Journal of Cardiology 2024年第9期16卷 502-507页

作者： Wen-Rui Hao Chun-Han Cheng Tzu-Hurng Cheng 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 medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305TaiwanChina department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328TaiwanChina

This editorial discusses the key findings presented in Batta and Hatwal’s recent paper titled“Excess cardiovascular mortality in men with non-alcoholic fatty liver disease:A cause for concern!”,which was published in the World Journal of *** original article highlights a notable correlation between nonalcoholic fatty liver disease(NAFLD)and increased cardiovascular mortality risk in *** present commentary explores the implications of their findings,discussing potential mechanisms,risk factors,and the urgent need for integrated clinical approaches to mitigate the dual burden of these *** should be placed on the importance of early detection,lifestyle modifications,and interdisciplinary collaboration for improving patient *** editorial aims to highlight the broad implications of NAFLD for cardiovascular health and to advocate for increased awareness and proactive management strategies within the medical community.

关键词： Non-alcoholic fatty liver disease Cardiovascular mortality Men's health Integrated clinical approaches Risk factors

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Impact of lifestyle interventions on pathogenesis of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2024年第20期30卷 2633-2637页

作者： Wafaa Mohamed Ezzat department of internal medicine Medical Research and Clinical Studies InstituteNational Research CenterGiza 12311Egypt

This editorial builds on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et *** carried out a critical examination of nonalcoholic fatty liver disease(NAFLD)pathogenesis and how lifestyle interventions could facilitate disease resolution,particularly highlighting that non-alcoholic steatohepatitis(NASH)is a severe form of *** discussion details that weight loss is a pivotal factor in disease outcomes:A 3%-5%reduction is enough for resolution in 50%of non-obese individuals,while a 7%-10%reduction achieves similar benefits in obese individuals,as demonstrated by magnetic resonance ***,the editorial underscores that such lifestyle changes are instrumental not only in resolving NAFLD but also in reversing hepatic steatosis and *** insights,derived from the research,emphasize the critical role of personalized lifestyle modifications in halting the progression of NAFLD to NASH and even reversing fibrosis,thus offering a template for effective patient management.

关键词： Nonalcoholic fatty liver disease Non-alcoholic steatohepatitis Diet Physical activity Life style

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Experience of primary intestinal lymphangiectasia in adults: Twelve case series from a tertiary referral hospital

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World Journal of Clinical Cases 2024年第4期12卷 746-757页

作者： Ji Eun Na Ji Eun Kim Sujin Park Eun Ran Kim Sung Noh Hong Young-Ho Kim Dong Kyung Chang department of internal medicine Inje University Haeundae Paik HospitalBusan 48108South Korea department of medicine Samsung Medical CenterSeoul 06351South Korea department of Pathology Samsung Medical CenterSeoul 06351South Korea

BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in ***,the absence of clear guidance from diagnosis to treatment and prognosis poses challenges for both physicians and *** To enhance understanding by investigating clinical presentation,diagnosis,treatment,complications,and prognoses in adult PIL *** We enrolled adult patients diagnosed with PIL between March 2016 and September *** primary outcome involved examining the diagnosis and treatment process of these *** secondary outcomes included identifying complications(infections,thromboembolism)and assessing prognoses(frequency of hospitalization and mortality)during the follow-up *** Among the 12 included patients,peripheral edema(100%)and diarrhea(75%)were the main presenting *** tests showed that all the pati-ents exhibited symptoms of hypoalbuminemia and ***,the predominant findings were edema of the small intestine(67%)and ascites(58%).The typical endoscopic finding with a snowflake appearance was observed in 75%of *** the 12 patients,two responded positive-ly to octreotide and sirolimus,and eight who could undergo maintenance therapy discontinued *** due to PIL led to infection in half of the patients,thromboembolism in three patients,and one *** PIL can be diagnosed in adults across various age groups,with different severity and treatment responses among patients,leading to diverse complications and ***,tailored treatments will be *** anticipate that our findings will contribute to the management of PIL,an etiology of protein-losing enteropathy.

关键词： Primary intestinal lymphangiectasia in adults Protein-losing enteropathy Diagnosis Treatment Prognosis

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Evaluating the role of large language models in inflammatory bowel disease patient information

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World Journal of Gastroenterology 2024年第29期30卷 3538-3540页

作者： Eun Jeong Gong Chang Seok Bang department of internal medicine Hallym University College of MedicineChuncheon 24253Gangwon-doSouth Korea

This letter evaluates the article by Gravina et al on ChatGPT’s potential in providing medical information for inflammatory bowel disease *** promising,it highlights the need for advanced techniques like reasoning+action and retrieval-augmented generation to improve accuracy and *** that simple question and answer testing is insufficient,it calls for more nuanced evaluation methods to truly gauge large language models’capabilities in clinical applications.

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Chat generative pre-trained transformer Large language model Artificial intelligence

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Real-world efficacy and safety of tofacitinib treatment in Asian patients with ulcerative colitis

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World Journal of Gastroenterology 2024年第13期30卷 1871-1886页

作者： Kentaro Kojima Kenji Watanabe Mikio Kawai Soichi Yagi Koji Kaku Maiko Ikenouchi Toshiyuki Sato Koji Kamikozuru Yoko Yokoyama Tetsuya Takagawa Masahito Shimizu Shinichiro Shinzaki department of Gastroenterology Hyogo Medical UniversityNishinomiya 663-8501Japan department of Gastroenterology Gifu University Graduate School of MedicineGifu 501-1194Japan department of internal medicine for Inflammatory Bowel Disease The University of ToyamaToyama 930-0194Japan Center for Clinical Research and Education Hyogo Medical UniversityNishinomiya 663-8501Japan

BACKGROUND Real-world data on tofacitinib(TOF)covering a period of more than 1 year for a sufficient number of Asian patients with ulcerative colitis(UC)are *** To investigate the long-term efficacy and safety of TOF treatment for UC,including clinical *** We performed a retrospective single-center observational analysis of 111 UC patients administered TOF at Hyogo medical university as a tertiary inflammatory bowel disease *** consecutive UC patients who received TOF between May 2018 and February 2020 were *** were followed up until August *** primary outcome was the clinical response rate at week *** outcomes included clinical remission at week 8,cumulative persistence rate of TOF administration,colectomy-free survival,relapse after tapering of TOF and predictors of clinical response at week 8 and week *** The clinical response and remission rates were 66.3%and 50.5%at week 8,and 47.1%and 43.5%at week 48,*** overall cumulative clinical remission rate was 61.7%at week 48 and history of anti-tumor necrosis factor-alpha(TNF-α)agents use had no influence(P=0.25).The cumulative TOF persistence rate at week 48 was significantly lower in patients without clinical remission than in those with remission at week 8(30.9%vs 88.1%;P<0.001).Baseline partial Mayo Score was significantly lower in responders vs non-responders at week 8(odds ratio:0.61,95%confidence interval:0.45-0.82,P=0.001).Relapse occurred in 45.7%of patients after TOF tapering,and 85.7%of patients responded within 4 wk after *** 6 patients with herpes zoster(HZ)developed the infection after achieving remission by *** TOF was more effective in UC patients with mild activity at baseline and its efficacy was not affected by previous treatment with anti-TNF-α*** relapsed patients responded again after re-increase of TOF and nearly half relapsed after tapering off *** attention is needed for tapering and H

关键词： Ulcerative colitis Tofacitinib Janus kinase inhibitor Real-world Biologics

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Investigating clubfoot in Saudi Arabia: Prevalence, factors, and future directions

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World Journal of Orthopedics 2024年第9期15卷 836-840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 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 editorial discusses the significant findings and implications of the study conducted by Alomran et *** retrospective study,soon to be published,provides valuable insights into the epidemiology of and risk factors associated with clubfoot in a specific Saudi *** highlighting the study’s key outcomes and discussing its broader implications for public health and clinical practices,this editorial aims to underscore the importance of continued research and targeted interventions in addressing congenital deformities such as clubfoot.

关键词： Clubfoot prevalence Saudi Arabia Congenital deformities Retrospective study Orthopedic epidemiology

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Mesenchymal stem cells: A promising therapeutic avenue for nonalcoholic fatty liver disease

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World Journal of Stem Cells 2024年第8期16卷 780-783页

Non-alcoholic fatty liver disease(NAFLD)is a pressing global health concern that is associated with metabolic syndrome and *** the basis of the insights provided by Jiang et al,this editorial presents an exploration of the potential of mesenchymal stem cells(MSCs)for NAFLD *** have numerous desirable characteristics,including immunomodulation,anti-inflammatory pro-perties,and tissue regeneration promotion,rendering them attractive candidates for NAFLD *** preclinical and early clinical studies have high-lighted the efficacy of MSCs in improving liver function and reducing disease severity in NAFLD ***,MSC heterogeneity,long-term safety concerns,and unoptimized therapeutic protocols remain substantial *** these challenges through standardized protocols and rigorous clinical trials is essential to the safe and successful application of MSCs in NAFLD *** research into MSC mechanisms and therapeutic optimization is required to improve treatments for NAFLD and related liver diseases.

关键词： Mesenchymal stem cells Non-alcoholic fatty liver disease Therapeutic potential Liver fibrosis Regenerative medicine Stem cell therapy Inflammation Clinical trials

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