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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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Hepatocellular Carcinoma Incidence and Mortality in the USA by Sex, Age, and Race: A Nationwide Analysis of Two Decades

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Journal of Clinical and Translational hepatology 2024年第2期12卷 172-181页

作者： Yazan Abboud Mohamed Ismail Hamza Khan Esli Medina-Morales Saqr Alsakarneh Fouad Jaber Nikolaos T.Pyrsopoulos department of internal medicine Rutgers New Jersey Medical SchoolNewarkNJUSA department of internal medicine University of Missouri-Kansas CityKansas CityMOUSA division of gastroenterology and hepatology Rutgers New Jersey Medical SchoolNewarkNJUSA

Background and Aims:While the incidence rates of hepa-tocellular carcinoma(HCC)are increasing,there are limited comprehensive data on demographic-specific incidence and mortality trends in the *** aimed to evaluate recent trends in HCC incidence and mortality among different de-mographic groups in the ***:Age-adjusted HCC incidence rates were calculated from the Centers for Disease Control's United States Cancer Statistics database,which combines incidence data on newly diagnosed cancer cases and covers approximately 98%of the population in the ***,age-adjusted HCC mortality rates were obtained from the Centers for Disease Control's National Center for Health Statistics database,which offers comprehensive Cov-erage spanning nearly 100%of deaths attributed to HCC in the *** were stratified by sex,age(older[≥55 years]and younger[<55 years]adults),race and ethnicity(Non-Hispanic White,Non-Hispanic Black,Hispanic,Non-Hispanic Asian/Pacific Islander,and Non-Hispanic American Indian/Alaska Native),and tumor stage at diagnosis(early and late).Annual and average annual percentage change(AAPC)were calculated using joinpoint regression.A sex-specific pairwise comparison was ***:Between 2001 and 2020,there were 467,346 patients diagnosed with HCC(26.0%women),with increasing incidence in both sexes without significant difference(p=0.65).In younger adults(78,169 patients),the incidence decreased in men but not in women(AAPC difference=-2.39,p=0.002).This was seen in various racial and ethnic groups,mostly driven by early-stage tumors(AAPC difference=-2.65,p=0.02).There were 329,973 deaths attributed to HCC between 2000 and 2020(28.4%women).In younger adults(43,093 deaths),mortal-ity decreased in men at a greater rate than in women(AAPC difference=1.61,p=0.007).This was seen in various racial and ethnic groups,most notably in non-Hispanic American Indian/Alaska Natives(AAPC difference=-4.51,p=0.01).Conclusions:Nationwide USA data,coveri

关键词： Liver cancer Hepatocellular carcinoma Incidence Mortality Epidemiology Health disparity

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Subnormal Serum Liver Enzyme Levels:A Review of Pathophysiology and Clinical Significance

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Journal of Clinical and Translational hepatology 2024年第4期12卷 428-435页

作者： Elham M.Youssef George Y.Wu Biochemistry department National Research CenterCairoEgypt department of medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Subnormal levels of liver enzymes,below the lower limit of normal on local laboratory reports,can be useful *** instance,subnormal levels of aminotransferases can be observed in vitamin B6 deficiency and chronic kidney *** alkaline phosphatase levels may indicate the presence of hypophosphatasia,Wilson's disease,deficiencies of divalent ions,or *** levels of gamma glutamyl transferase may be seen in cases of acute intrahepatic cholestasis,the use of certain medications,and in bone ***,subnormal levels of 5'-nucleotidase have been reported in lead poisoning and nonspherocytic hemolytic *** aim of this review is to bring attention to the fact that subnormal levels of these enzymes should not be ignored as they may indicate pathological conditions and provide a means of early diagnosis.

关键词： Transaminases Vitamin B6 Celiac disease Renal insufficiency Hepatolenticular Degeneration Crohn disease Malnutrition Clofibrate Bone diseases Lead poisoning Anemia Hemolytic

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Heterogeneity in the risk of incident liver cirrhosis driven by PNPLA3 genotype and diabetes among different populations

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 115-118页

作者： Bo Kyung Koo Dong Hyeon Lee Jeong Hwan Park Won Kim division of Endocrinology Department of Internal MedicineBoramae Medical CenterSeoulRepublic of Korea department of internal medicine Seoul National University College of MedicineSeoulRepublic of Korea division of gastroenterology and hepatology Department of Internal MedicineBoramae Medical CenterSeoulRepublic of Korea department of Pathology Boramae Medical CenterSeoulRepublic of Korea

Advanced fibrosis determines the prognosis of nonalcoholic fatty liver disease(NAFLD);therefore,accurate risk-prediction for advanced fibrosis is fundamental in the management of NAFLD(1).Targeted screening for advanced fibrosis in high-risk populations,such as those with type 2 diabetes,obesity with metabolic complications,a family history of cirrhosis,or significant alcohol use is recommended for implementing early intervention to prevent future adverse hepatic outcomes of NAFLD(2,3).Non-invasive tests including fibrosis-4 index(FIB-4)and liver stiffness measurement(LSM)are recommended to identify individuals at a higher risk of liver-related events(1,2).In addition to clinical classifications,such as FIB-4;genetic information provides further stratification for liver-related outcomes(4).

关键词： Nonalcoholic fatty liver disease(NAFLD) cirrhosis PNPLA3-rs738409

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MicroRNAs in hepatocellular carcinoma treatment:Charting the path forward

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World Journal of gastroenterology 2024年第11期30卷 1470-1474页

作者： Hong T Lin Antonio F Alvarez Castaneda Somashekar G Krishna Khalid Mumtaz division of gastroenterology Hepatology and NutritionDepartment of MedicineThe Ohio State University Wexner Medical CenterColumbusOH 43210United States

MicroRNAs(miRNAs)are recognized for their involvement in the regulation of gene expression and exhibit significant potential in both the prognostic assessment and treatment of hepatocellular carcinoma(HCC).HCC,like other tumors,seldom occurs in isolation;instead,it evolves within a microenvironment featuring oncogenic and tumor-suppressive *** combined with suitable delivery vehicles,miRNA technology provides the capability to directly engage with these elements,thereby hindering tumor formation and *** research in this domain holds the promise of enabling a more efficacious and multi-modal treatment approach for HCC in the near future.

关键词： Hepatocellular carcinoma Tumor microenvironment MicroRNA Mesenchymal stem cell Exosome

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Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

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World Journal of gastroenterology 2024年第5期30卷 499-508页

作者： Nobuaki Hasegawa Akihiko Oka Muyiwa Awoniyi Yuri Yoshida Hiroshi Tobita Norihisa Ishimura Shunji Ishihara department of internal medicine II Shimane University Faculty of MedicineIzumo 693-8501ShimaneJapan department of gastroenterology Hepatology and NutritionDigestive Disease and Surgery InstituteHepatology SectionCleveland ClinicClevelandOH 44195United States Clinical Laboratory division Shimane University HospitalIzumo 693-8501ShimaneJapan division of hepatology Shimane University HospitalIzumo 693-8501Japan

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been *** this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each *** SUMMARY Case 1:A 90-year-old man with nausea and *** diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal ***,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content ***,US indicated enhanced passage upon abdominal massage on the right *** day 2,the patient could eat comfortably with the optimal position and *** 2:An 87-year-old woman with *** the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal *** The optimal position for SMA syndrome varies among *** US appears to be a valuable tool in improving patient outcomes.

关键词： Superior mesenteric artery syndrome Wilkie’s syndrome Cast syndrome Aorto-mesenteric compass syndrome Ultrasonography Case report

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Risk of hepatitis B virus reactivation in oncological patients treated with tyrosine kinase inhibitors:A case report and literature analysis

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World Journal of gastroenterology 2024年第9期30卷 1253-1256页

作者： Francesca Colapietro Nicola Pugliese Antonio Voza Alessio Aghemo Stella De Nicola department of Biomedical Sciences Humanitas UniversityMilan 20072Italy division of internal medicine and hepatology Department of GastroenterologyHumanitas Research HospitalMilan 20089Italy department of Emergency Humanitas Research HospitalMilan 20089Italy

Hepatitis B virus(HBV)reactivation(HBVr)represents a severe and potentially life-threatening condition,and preventive measures are available through blood test screening or prophylactic therapy *** assessment of HBVr traditionally considers factors such as HBV profile,including hepatitis B surface antigen(HBsAg)and antibody to hepatitis B core antigen,along with type of medication(chemotherapy;immunomodulants).Nevertheless,consideration of possible patient’s underlying tumor and the specific malignancy type(solid or hematologic)plays a crucial role and needs to be assessed for decision-making process.

关键词： Chronic hepatitis B Reactivation Nucleoside analogue Tyrosine kinase inhibitors Onco-hematology

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Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 51-60页

作者： Ga Hee Kim Yeong Chan Lee Tae Jun Kim Sung Noh Hong Dong Kyung Chang Young-Ho Kim Dong-Hoon Yang Chang Mo Moon Kyunga Kim Hyun Gun Kim Eun-Ran Kim division of gastroenterology Department of Internal MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea department of Digital Health Samsung Advanced Institute for Health Science and TechnologySungkyunkwan University School of MedicineSeoul 06351South Korea division of gastroenterology Department of Internal MedicineSamsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea division of gastroenterology Department of Internal MedicineEwha Womans UniversitySeoul 07985South Korea Biomedical Statistics Center Samsung Medical CenterSeoul 06351South Korea division of gastroenterology Department of Internal MedicineSoonchunhyang University College of MedicineSeoul 04401South Korea

BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several *** To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in *** This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC,and assess the numbers of diagnostic colonoscopies and colonoscopic ***-related complications by age group were also *** The incidence of CRC showed a rapid increase,then decreased after 2012 in the 50-75 year-age *** the study period,the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of *** 2009,the increase has been rapid,showing a pattern similar to the increase in *** rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after *** rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of *** The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies *** the risk of colonoscopy-related hospitalization and death is high in the elderly,if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75,colonoscopy-related complications can be reduced for those aged 76 years or over.

关键词： Colorectal cancer Preinvasive colorectal cancer Colorectal polypectomy Colonoscopy

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Genetics of Gallstone Disease and Their Clinical Significance: A Narrative Review

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Journal of Clinical and Translational hepatology 2024年第3期12卷 316-326页

作者： Christopher J.Costa Minh Thu T.Nguyen Haleh Vaziri George Y.Wu department of medicine University of Connecticut Health CenterFarmingtonCTUSA division of gastroenterology and hepatology University of Connecticut Health CenterFarmingtonCTUSA

Gallstone(GS)disease is common and arises from a combination of genetic and environmental *** genetic abnormalities specifically leading to cholesterol GSs are rare,there are clinically significant gene variants associated with cholesterol *** contrast,most bilirubin GSs can be attributed to genetic *** pathogenesis of cholesterol and bilirubin GSs differs *** GSs are notably influenced by genetic variants within the ABC protein superfamily,including ABCG8,ABCG5,ABCB4,and ABCB11,as well as genes from the apolipoprotein family such as ApoB100 and ApoE(especially the E3/E3 and E3/E4 variants),and members of the MUC ***,bilirubin GSs are associated with genetic variants in highly expressed hepatic genes,notably UGT1A1,ABCC2(MRP2),ABCC3(MRP3),CFTR,and MUC,alongside genetic defects linked to hemolytic anemias and conditions impacting *** genetic cases constitute a small portion of GS disease,recognizing genetic predisposition is essential for proper diagnosis,treatment,and genetic counseling.

关键词： Gallstones Cholelithiasis ATP-binding cassette transporters ABCG8 protein Human UDP-glucuronosyltransferase A1

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Heritable Chronic Cholestatic Liver Diseases:A Review

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Journal of Clinical and Translational hepatology 2024年第8期12卷 726-738页

作者： Jasmine Tidwell George Y.Wu department of medicine University of Connecticut Health CenterFarmingtonCTUSA division of gastroenterology-hepatology University of Connecticut Health CenterFarmingtonCTUSA

Chronic cholestasis due to heritable causes is usually diagnosedin ***,many cases can present andsurvive into *** time course varies considerablydepending on the underlying *** data usuallyreveal elevated conjugated hyperbilirubinemia,alkalinephosphatase,and gamma-glutamyl *** be asymptomatic;however,when present,the typicalsymptoms are pruritus,jaundice,fatigue,and *** diagnostic methods and management requireddepend on the underlying *** development of genome-wide associated studies has allowed the identificationof specific genetic mutations related to the pathophysiologyof cholestatic liver *** aim of this review was tohighlight the genetics,clinical pathophysiology,presentation,diagnosis,and treatment of heritable etiologies of chroniccholestatic liver disease.

关键词： Chronic cholestasis Cholestatic liver disease Congenital hepatic fibrosis Caroli disease Caroli syndrome Alagille syndrome Biliary atresia

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