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Endoscopic treatment of scarred polyps with a non-thermal device(Endorotor):A review of the literature

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World Journal of gastroenterology 2024年第12期30卷 1706-1713页

作者： Mariam Zaghloul Hameed Rehman Stefano Sansone Konstantinos Argyriou Adolfo Parra-Blanco Department of hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversitKafr-Elshikh 33516Egypt Department of gastroenterology service Nottingham City Hospital CampusNottingham University Hospitals NHS TrustNottingham NG51PBUnited Kingdom Department of gastroenterology University Hospital of LarissaLarissa 41334Greece NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and University of NottinghamNottingham NG72UHUnited Kingdom

Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic *** procedures have evolved over the past few years from endoscopic mucosal resection(EMR)to more advanced techniques,such as endoscopic submucosal dissection and endo-scopic full-thickness *** resection and disease eradication are the ultimate goals of ER-based techniques,and novel devices have been developed to achieve these *** EndoRotor®Endoscopic Powered Resection System(Interscope Medical,Inc.,Northbridge,Massachusetts,United States)is one such *** EndoRotor is a powered resection tool for the removal of alimentary tract mucosa,including post-EMR persistent lesions with scarring,and has both CE Mark and FDA *** review covers available published evidence documenting the usefulness of EndoRotor for the management of recurrent colorectal polyps.

关键词： EndoRotor Scarred polyps Recurrent polyps Colorectal cancer Colorectal polyps

A comprehensive look at the psychoneuroimmunoendocrinology of spinal cord injury and its progression: mechanisms and clinical opportunities

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Military Medical Research 2024年第2期11卷 228-267页

作者： Miguel A.Ortega Oscar Fraile-Martinez Cielo García-Montero Sergio Haro Miguel Ángel Álvarez-Mon Diego De Leon-Oliva Ana M.Gomez-Lahoz Jorge Monserrat Mar Atienza-Pérez David Díaz Elisa Lopez-Dolado Melchor Álvarez-Mon Department of Medicine and Medical Specialities University of Alcala28801 Alcala de HenaresSpain Ramón y Cajal Institute of Sanitary Research(IRYCIS) 28034 MadridSpain Department of Psychiatry and Mental Health Hospital Universitario Infanta Leonor28031 MadridSpain service of Rehabilitation National Hospital for Paraplegic PatientsCarr.de la PeraledaS/N45004 ToledoSpain Immune System Diseases‑Rheumatology service and Internal Medicine University Hospital Príncipe de Asturias(CIBEREHD)28806 Alcala de HenaresSpain

Spinal cord injury(SCI)is a devastating and disabling medical condition generally caused by a traumatic event(primary injury).This initial trauma is accompanied by a set of biological mechanisms directed to ameliorate neural damage but also exacerbate initial damage(secondary injury).The alterations that occur in the spinal cord have not only local but also systemic consequences and virtually all organs and tissues of the body incur important changes after SCI,explaining the progression and detrimental consequences related to this ***(PNIE)is a growing area of research aiming to integrate and explore the interactions among the different systems that compose the human organism,considering the mind and the body as a *** initial traumatic event and the consequent neurological disruption trigger immune,endocrine,and multisystem dysfunction,which in turn affect the patient's psyche and *** the present review,we will explore the most important local and systemic consequences of SCI from a PNIE perspective,defining the changes occurring in each system and how all these mechanisms are ***,potential clinical approaches derived from this knowledge will also be collectively presented with the aim to develop integrative therapies to maximize the clinical management of these patients.

关键词： Spinal cord injury(SCI) Psychoneuroimmunoendocrinology(PNIE) Secondary injury Immunoinflammatory dysfunction Gut microbiota Translational opportunities

Update in lean metabolic dysfunction-associated steatotic liver disease

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World Journal of hepatology 2024年第3期16卷 452-464页

作者： Karina Sato-Espinoza Perapa Chotiprasidhi Mariella R Huaman Javier Díaz-Ferrer Division of gastroenterology and hepatology Department of MedicineMayo ClinicRochesterMN 55902United States Obesity and Metabolic Center for Obesity and Metabolic HealthLima 02002LimaPeru hepatology service Department of Digestive DiseasesHospital Nacional Edgardo Rebagliati MartinsLima 02002LimaPeru Medicine Faculty Universidad San Martin de PorresLima 02002LimaPeru gastroenterology service Clinica InternacionalLima 02002LimaPeru

BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in *** condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase *** patients account for approximately 10%-15%of the MASLD ***,the pathogenesis is complex and is not well *** To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new *** We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD *** include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian *** We include 85 studies in our *** findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic *** risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean *** non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean *** modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser ***,lean NAFLD patients ex

关键词： Lean Non-obese Non-alcoholic fatty liver disease Metabolic dysfunction-associated fatty liver disease Metabolic dysfunction-associated steatotic liver disease Guidelines Diagnosis Management Pathogenesis Treatment

Factors Associated with Renal Impairment in Patients on Tenofovir for Chronic Hepatitis B in Yaoundé (Cameroon)

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Open Journal of gastroenterology 2024年第1期14卷 18-30页

作者： Antonin Wilson Ndjitoyap Ndam Sonia Charlsia Ewuo Shu Mahamat Maimouna Winnie Bekolo Nga Isabelle Dang Babagna Paul Talla Mathurin Kowo Firmin Ankouane Andoulo Gloria Enow Ashuntantang hepato Gastroenterologist service Yaoundé General Hospital Yaoundé Cameroon Internal Medicine Department Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Clinical Sciences Faculty of Health Sciences University of Bamenda Bamenda Cameroon Nephrologist service Yaoundé General Hospital Yaoundé Cameroon Department of Clinical Sciences Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon hepato Gastroenterologist service Centre Medical la Cathedrale Yaoundé Cameroon

Background: Tenofovir (TFV) is widely used to treat patients with hepatitis B virus (HBV) infection. But kidney abnormalities are the main concern using this drug. Few studies have described the renal impairment due to the TFV in chronic hepatitis B (CHB) in Sub-Saharan Africa. The objective was to evaluate factors associated with renal impairment observed in patients on TFV for CHB. Method: It was a hospital based cross sectional prospective study carried out from June 2023 to July 2023 in Yaoundé (Cameroon) and included any patient treated with TFV for CHB during at least a period of 6 months. For each participant, we collected in the medical report socio-demographic data, clinical data, baseline creatinine, treatment information (type of TFV which was Disoproxil Fumarate (TDF) or Alafenamide (TAF), duration). Then, we collected blood samples to measure serum creatinine and phosphate levels and urine dipstick analysis. Factors associated with renal impairment were assessed with the Odds Ratio. A p value of Results: A total of 60 participants were included. The median age was 44 years [36-55] and median duration of TFV therapy was 17.5 months [11.7-25.7]. The prevalence of reduced eGFR (Conclusion: Kidney function was impaired in some patients receiving TFV for CHB. It should be monitored, particularly after 36 months and for those receiving TDF prodrug.

关键词： Chronic Hepatitis B Tenofovir Factors Associated Renal Impairment Cameroon

Endoscopic polidocanol foam sclerobanding for the treatment of grade II-III internal hemorrhoids:A prospective,multi-center,randomized study

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World Journal of gastroenterology 2024年第27期30卷 3326-3335页

作者： Chun-Ying Qu Fei-Yu Zhang Yi Zhang Ming-Ming Li Zheng-Hong Li Mei-Hong Cai Lei-Ming Xu Feng Shen Wen Wang Wu-Lian Lin Feng-Yu Gao Hao Zhang Guang-Yu Chen Department of gastroenterology&Endoscopy Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of gastroenterology The 900th Hospital of the People’s Liberation Army Joint Service Support ForceFuzhou 350025Fujian ProvinceChina Department of Endoscopy Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao UniversityJinan 250014Shandong ProvinceChina Department of Endoscopy Baoshan People’s Hospital of Yunnan ProvinceBaoshan 678000Yunnan ProvinceChina Department of gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural *** To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and *** This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL *** patients were followed-up for 12 ***-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile *** One hundred and ninety-five patients were enrolled,with 98 in the EFSB *** was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of *** prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours *** median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

关键词： Internal hemorrhoids Endoscopic therapy Polidocanol foam Sclerotherapy Rubber band ligation Sclerobanding

Chitin-glucan improves important pathophysiological features of irritable bowel syndrome

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World Journal of gastroenterology 2024年第16期30卷 2258-2271页

作者： Caroline Valibouze Caroline Dubuquoy Philippe Chavatte Michaël Genin Veronique Maquet Salvatore Modica Pierre Desreumaux Christel Rousseaux Department of Digestive Surgery and Transplantation Lille UniversityLille 59037France Intestinal Biotech Development Facultéde MédicineLille 59045France U1286-INFINITE-Institute for Translational Research in Inflammation Universitéde LilleLille 59000France ULR 2694-METRICS Évaluation des Technologies de santéet des Pratiques MédicalesUniversity of LilleLille 59000France KitoZyme SA Institution SociétéAnonymeZone 2Parc des Hauts SartsRue de MilmortHerstal 4040Belgium hepato-gastroenterology Department Lille University HospitalLille 59037France

BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequent and debilitating conditions leading to gastroenterological ***,recommended treatments remain limited,yielding only limited therapeutic ***-glucan(CG)is a novel dietary prebiotic classically used in humans at a dosage of 1.5-3.0 g/d and is considered a safe food ingredient by the European Food Safety *** provide an alternative approach to managing patients with IBS,we performed preclinical molecular,cellular,and animal studies to evaluate the role of chitin-glucan in the main pathophysiological mechanisms involved in *** To evaluate the roles of CG in visceral analgesia,intestinal inflammation,barrier function,and to develop computational molecular *** Visceral pain was recorded through colorectal distension(CRD)in a model of long-lasting colon hypersensitivity induced by an intra-rectal administration of TNBS[15 milligrams(mg)/kilogram(kg)]in 33 Sprague-Dawley *** pressure was regularly assessed during the 9 wk-experiment(weeks 0,3,5,and 7)in animals receiving CG(n=14)at a human equivalent dose(HED)of 1.5 g/d or 3.0 g/d and compared to negative control(tap water,n=11)and positive control(phloroglucinol at 1.5 g/d HED,n=8)*** anti-inflammatory effect of CG was evaluated using clinical and histological scores in 30 C57bl6 male mice with colitis induced by dextran sodium sulfate(DSS)administered in their drinking water during 14 ***-29 cells under basal conditions and after stimulation with lipopolysaccharide(LPS)were treated with CG to evaluate changes in pathways related to analgesia μ-opioid receptor(MOR),cannabinoid receptor 2(CB2),peroxisome proliferator-activated receptor alpha,inflammation[interleukin(IL)-10,IL-1b,and IL-8]and barrier function[mucin 2-5AC,claudin-2,zonula occludens(ZO)-1,ZO-2]using the real-time PCR *** modelling of CG,LPS,lipoteichoic acid(LTA),and phospholipomannan(PLM)was developed,and the abili

关键词： Chitin-glucan Irritable bowel syndrome Abdominal pain Inflammation Intestinal barrier Molecular modelling Microbial cell walls chelation

NAD+associated genes as potential biomarkers for predicting the prognosis of gastric cancer

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Oncology Research 2024年第2期32卷 283-296页

作者： XIANGDONG SUN HUIJUAN WEN FAZHAN LI IHTISHAM BUKHARI FEIFEI REN XIA XUE PENGYUAN ZHENG YANG MI Henan Key Laboratory for Helicobacter Pylori&Microbiota and GI Cancer Marshall Medical Research CenterThe Fifth Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Department of gastroenterology The Fifth Affiliated Hospital of Zhengzhou UniversityZhengzhouChina

Nicotinamide adenine dinucleotide(NAD+)plays an essential role in cellular metabolism,mitochondrial homeostasis,inflammation,and ***,the role of NAD+-regulated genes,including coding and long non-coding genes in cancer development is poorly *** constructed a prediction model based on the expression level of NAD+metabolism-related genes(NMRGs).Furthermore,we validated the expression of NMRGs in gastric cancer(GC)tissues and cell lines;additionally,β-nicotinamide mononucleotide(NMN),a precursor of NAD+,was used to treat the GC cell lines to analyze its effects on the expression level of NMRGs lncRNAs and cellular proliferation,cell cycle,apoptosis,and senescence-associated secretory phenotype(SASP).A total of 13 NMRGs-related lncRNAs were selected to construct prognostic risk signatures,and patients with high-risk scores had a poor *** immune checkpoint genes were upregulated in the high-risk *** addition,cell cycle,epigenetics,and senescence were significantly downregulated in the high-risk ***,we found that the levels of immune cell infiltration,including CD8 T cells,CD4 naïve T cells,CD4 memory-activated T cells,B memory cells,and naïve B cells,were significantly associated with risk ***,the treatment of NMN showed increased proliferation of AGS and MKN45 *** addition,the expression of SASP factors(IL6,IL8,IL10,TGF-β,and TNF-α)was significantly decreased after NMN *** conclude that the lncRNAs associated with NAD+metabolism can potentially be used as biomarkers for predicting clinical outcomes of GC patients.

关键词： NAD+ LncRNAs Cancer Cell infiltration Prognosis Tumor microenvironment

Evaluation of the Strategy and Efficacy of Treatment of Chronic Viral Hepatitis C with the Sofosbuvir/Daclatasvir Combination in a Resource-Limited Country

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Open Journal of gastroenterology 2024年第7期14卷 233-240页

作者： Mayanna Habkreo Ali Mahamat Moussa Adama Ahmed Ngare Abdraman Kossou Tahir Mahamat Saleh Maire Dehainsala Mahamat Ali Hachim Mahamat Ali Bolti Oumaima Djarma Joseph Madtoingue service de Gastroentrologie/Mdecine Interne du Centre Hospitalier Universitaire la Rfrence Nationale NDjamena Chad service de Gastroentrologie du Centre Hospitalier Universitaire la Renaissance NDjamena Chad service de Maladies Infectieuses du Centre Hospitalier Universitaire la Renaissance NDjamena Chad service de Maladies Infectieuses du Centre Hospitalier Universitaire la Rfrence Nationale NDjamena Chad

Introduction: The treatment of viral hepatitis C (HCV), a major public health problem, has evolved considerably since the introduction of direct-acting anti-virals (DAAs). The aim of this study was to evaluate the strategy for initiating treatment with Sofosbuvir/Daclatasvir, and also to assess its efficacy. Patients and Methods: Included were patients aged at least 15 years, with detectable hepatitis C viremia and treated with a pan-genotypic Sofosbuvir/Daclatasvir regimen at the Centre “Hospitalier Universitaire la Référence Nationale de N’Djamena” between October 2019 and October 2023. The APRI score was used to assess fibrosis. Cure was defined by an undetectable viral load 12 weeks after the end of treatment. Results: A total of 835 patients were included (sex ratio 1.55, mean age 50.5 ± 13.73, extremes 20 and 84 years). The 60 - 69 age group was the most represented. The mean APRI score was 0.42 ± 0.29, with extremes of 0.019 and 1.84. The mean viral load was 2,316,193.086 IU/mL. All subjects had good renal function. Cytolysis was absent in 70% of cases. Without genotyping, a pan-genotypic regimen was used in all patients: Sofosbuvir (400 mg)/Daclatasvir (60 mg). The cure rate was 99.4%, with good tolerability. However, four cases of failure were recorded out of the 668 patients who underwent follow-up HCV-PCR testing after 12 weeks of treatment. Conclusion: The Sofosbuvir/Daclatasvir regimen is highly effective, with an excellent safety profile. However, the still high cost of these molecules limits their accessibility to a large proportion of patients.

关键词： Efficacy Tolerance Sofosbuvir/Daclatasvir HCV Chad

Eradication Treatment of Helicobacter pylori Infection: Evaluation of Therapeutic Strategies in N’Djamena

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Open Journal of gastroenterology 2024年第2期14卷 59-67页

作者： Mayanna Habkréo Ali Mahamat Moussa Tahir Mahamat Saleh Djerabet Franckly Fany Haby Mairé Dehainssala Adama Ngaré Mahamat Ali Hachim service de Medecine Interne et Gastroenterologie Centre Hospitalier Universitaire La Reference Nationale N’Djamena Tchad service de Medecine Interne Centre Hospitalier Universitaire La Renaissance N’Djamena Tchad service de Médecine Hopital de l’Amitié Tchad-Chine N’Djamena Tchad

Background: Helicobacter pylori (Hp) infection is the most widespread bacterial infection in the world. The infection is generally acquired in childhood, but can persist into adulthood. Eradication therapy has undergone several modifications. The aim of this study was to evaluate the different therapeutic strategies used in the eradication of Helicobacter pylori infection in the Centre Hospitalier Universitaire La Reference Nationale of N’Djaména. Patients and Methods: This was a prospective, descriptive analytical study spread over one year, from September 2021 to September 2022. Patients at least 15 years of age presenting with dyspeptic symptoms, seen consecutively in a hepato-gastroenterology consultation and with a positive stool test for H. pylori infection, were included in the study. Equally, 1/3 of patients were treated with dual or triple therapy. The remaining third received quadritherapy. Results: A total of 268 patients were included in the study (mean age 38.40 ± 14.66 with extremes of 16 and 80 years). Males predominated in 58% of cases. Overall therapeutic efficacy was 88.9%. According to different therapeutic strategies, efficacy was 90.75% for dual therapy with PPI (Rabeprazole) and Amoxicillin. On the other hand, efficacy was 87% and 88.88% for PPI-based triple therapy and dual antibiotic therapy, and for PPI-based quadruple therapy and triple antibiotic therapy. Conclusion: H. pylori infection is a common disease in Chad. Dual therapy with rabeprazole combined with a high dose of amoxicillin over a period of at least two weeks showed similar if not better efficacy than triple or quadruple therapy.

关键词： Helicobacter pylori Therapeutic Strategies Eradication Dyspepsia Chad