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Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

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World Journal of Methodology 2025年第1期15卷 60-71页

作者： Karina Fatakhova Faisal Inayat Hassam Ali Pratik Patel Attiq Ur Rehman Arslan Afzal Muhammad Sarfraz Shiza Sarfraz Gul Nawaz Ahtshamullah Chaudhry Rubaid Dhillon Arthur Dilibe Benjamin Glazebnik Lindsey Jones Emily Glazer Division of gastroenterology and Hepatology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Department of internal medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of internal medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of internal medicine St.Dominic's HospitalJacksonMS 39216United States Department of gastroenterology Hepatologyand NutritionCleveland Clinic FoundationClevelandOH 44195United States Department of internal medicine Mather Hospital and Hofstra University ZuckerSchool of MedicinePort JeffersonNY 11777United States

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not *** practice guidelines include male gender as a predisposing factor for BE and *** population-based clinical evidence regarding female gender remains *** To study comparative trends of gender disparities in patients with BE in the United *** A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)*** with a primary or secondary diagnosis code of BE were *** major outcome of interest was determining the gender disparities in patients with *** analysis for respective outcomes for females was also reported to ascertain any time-based *** We identified 1204190 patients with BE for the study *** the included patients,717439(59.6%)were men and 486751(40.4%)were *** mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(***),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of *** and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among

关键词： Barrett’s esophagus Gender disparity Epidemiological trends Esophageal adenocarcinoma Screening endoscopy Female gender Risk factors

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Regulation of the intestinal immune system by flavonoids and its utility in chronic inflammatory bowel disease

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World Journal of gastroenterology 2018年第8期24卷 877-881页

作者： Harald Peter Hoensch Benno Weigmann private practice gastroenterology Marien hospital Department of medicine 1 University Medical Center

Flavonoids are phytochemicals which can regulate the activity of the intestinal immune system. In patients with chronic inflammatory bowel disease(IBD) there is an overexpression and imbalance of the components of the inflammatory immune reactions which are chronically activated. Suppression of inflammation can be achieved by anti-inflammatory drugs which are used in clinical medicine but these can cause serious side effects. Flavonoids can have natural immunosuppressive properties and inhibit the activation of immune cells and its effectors(chemokines, TNF-, cytokines). Phytochemicals such as flavonoids bind to the nuclear Ah(aryl hydrocarbon)-receptor thereby stimulating protective enzyme activities. As shown by clinical evidence in patients and by experimental work some flavonoids(apigenin, epigallocatechin gallate) were effective in the inhibition of inflammation. Instead of or additionally to anti-inflammatory drugs flavonoids can be used in IBD patients to treat the over-reactive immunologic system. This is accomplished by upregulation of the Ah-receptor. Flavonoids interact with toll-like receptors expressing on the surface of immune cells, then they were internalized to the cytosol and transferred into the nucleus, where they were attached to the Ah-receptor. The Ah-receptor binds to the Ah-R nuclear translocator and via Ah response element beneficial protective enzymes and cytokines are induced, leading to upregulation of the anti-inflammatory system.

关键词： Flavonoids Inflammatory bowel disease Ah-receptor

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Proton pump inhibitors in cirrhosis:Tradition or evidence based practice?

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World Journal of gastroenterology 2008年第19期14卷 2980-2985页

作者： Francesca Lodato Francesco Azzaroli Maria Di Girolamo Valentina Feletti Paolo Cecinato Andrea Lisotti Davide Festi Enrico Roda Giuseppe Mazzella Department of internal medicine and gastroenterology Gastroenterology UnitUniversity of Bologna

Proton Pump Inhibitors (PPI) are very effective in inhibiting acid secretion and are extensively used in many acid related diseases. They are also often used in patients with cirrhosis sometimes in the absence of a specific acid related disease, with the aim of preventing peptic complications in patients with variceal or hypertensive gastropathic bleeding receiving multidrug treatment. Contradicting reports support their use in cirrhosis and evidence of their efficacy in this condition is poor. Moreover there are convincing papers suggesting that acid secretion is reduced in patients with liver cirrhosis. With regard to Helicobacter pylori (H pylori) infection, its prevalence in patients with cirrhosis is largely variable among different studies, and it seems that H pylori eradication does not prevent gastro-duodenal ulcer formation and bleeding. With regard to the prevention and treatment of oesophageal complications after banding or sclerotherapy of oesophageal varices, there is little evidence for a protective role of PPI. Moreover, due to liver metabolism of PPI, the dose of most available PPIs should be reduced in cirrhotics. In conclusion, the use of this class of drugs seems more habit related than evidence- based eventually leading to an increase in health costs.

关键词： Proton pump inhibitors Cirrhosis H pylori Peptic ulcer CYP P450

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New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum:A case series

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World Journal of gastroenterology 2017年第17期23卷 3084-3091页

作者： Johanna Wilmsen Robert Baumbach Dietmar Stüker Vincens Weingart Frank Neser Stefan Karl Golder Christof Pfundstein Ellen Claudia Notzel Thomas Rosch Siegbert Faiss Department of gastroenterology and Interventional Endoscopy Asklepios Hospital BarmbekSemmelweis UniversityMedical Faculty Department of Interdisciplinary Endoscopy University Medical Center Tübingen Department of internal medicine Garmisch-Partenkirchen Medical Center Department of internal medicine II Hospital Chemnitz Department of internal medicine III private practice for internal medicine and gastroenterology Department of internal medicine and gastroenterology Sana Hospital Lichtenberg Department of Interdisciplinary Endoscopy University Medical Center Hamburg-Eppendorf

AIMTo report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible *** November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum. The septum was divided by the staple rows under flexible endoscopic *** eleven patients (64.7%) the stapler successfully divided the septum completely. Mean procedure time was 21 min, medium size of the septum was 2.8 cm (range 1.5 cm to 4 cm). In four patients the septum was shorter than 3 cm, in seven longer than 3 cm. To divide the septum, averagely 1.3 stapler cartridges were used. Two minor bleedings occurred. Major adverse events like perforation or secondary haemorrhage did not occur. After an average time of two days patients were discharged from the hospital. In 6 patients (35.3%) the stapler failed due to a thick septum or insufficient reclination of the head. Follow up endoscopy was performed after an average of two months in 9 patients; 4 patients (44.4%) were free of symptoms, 5 patients (55.6%) stated an improvement. A relapse of symptoms did not *** endoscopic Zenker diverticulotomy by using a surgical stapler is a new, safe and efficient treatment modality. A simultaneously tissue opening and occlusion prevents major complications.

关键词： Zenker’s diverticulum Flexible endoscopic treatment Stapler technique Overtube Surgical stapler

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Emerging role of bioflavonoids in gastroenterology:Especially their effects on intestinal neoplasia

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World Journal of Gastrointestinal Oncology 2011年第5期3卷 71-74页

作者： Harald P Hoensch Reinhard Oertel Marien-Hospital Private Practice of Internal Medicine Department of Clinical Pharmacology Technical University of Dresden

Flavonoids,secondary plant products which could be essential for normal physiology in humans and animals,may be the vitamins of the next *** belong to the polyphenols and possess antioxidative,anti-inflammatory,antimutagenic and anticarcinogenic *** the various flavonoid species,tea flavonoids such as apigenin (from camomile) and epigallocatechin gallate (EGCG from green tea) can be used for the prevention of intestinal neoplasia,especially for adenoma and cancer prevention in the gastrointestinal *** experimental studies with molecular and biological end points support the therapeutic efficacy of *** studies with cohorts and case-control trials suggest that flavonoids are effective in tertiary bioprevention but,as yet,there are no controlled randomized clinical *** can inhibit inflammatory pathways and could be useful for chronic inflammatory bowel *** deficiency syndromes could be therapeutic targets in the future.

关键词： Flavonoids Intestinal neoplasia Cancer prevention Apigenin Epigallocatechin gallate Inhibition of colon cancer cells

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Chronic intestinal pseudo-obstruction

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World Journal of gastroenterology 2008年第19期14卷 2953-2961页

作者： Alexandra Antonucci Lucia Fronzoni Laura Cogliandro Rosanna F Cogliandro Carla Caputo Roberto De Giorgio Francesca Pallotti Giovanni Barbara Roberto Corinaldesi Vincenzo Stanghellini Department of internal medicine and gastroenterology University of Bologna

Chronic intestinal pseudo-obstruction (CIPO) is a se- vere digestive syndrome characterized by derangement of gut propulsive motility which resembles mechanical obstruction, in the absence of any obstructive process. Although uncommon in clinical practice, this syndrome represents one of the main causes of intestinal failure and is characterized by high morbidity and mortality. It may be idiopathic or secondary to a variety of diseases. Most cases are sporadic, even though familial forms with either dominant or recessive autosomal inheritance have been described. Based on histological features in- testinal pseudo-obstruction can be classified into three main categories:neuropathies, mesenchymopathies, and myopathies, according on the predominant involvement of enteric neurones, interstitial cells of Cajal or smooth muscle cells, respectively. Treatment of intestinal pseu- do-obstruction involves nutritional, pharmacological and surgical therapies, but it is often unsatisfactory and the long-term outcome is generally poor in the majority of cases.

关键词： Chronic intestinal pseudo-obstruction Smallbowel manometry Immunohistochemistry Prokinetics Intestinal transplantation

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KML001, an arsenic compound, as salvage chemotherapy in refractory biliary tract cancers: A prospective study

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 62-66页

作者： Jung Hyun Jo Huapyong Kang Hee Seung Lee Moon Jae Chung Jeong Youp Park Seungmin Bang Seung Woo Park Si Young Song Division of gastroenterology Department of Internal Medicine Severance Hospital Yonsei University College of Medicine

Background: Sodium meta-arsenite(NaAsO_2, KML001) is a potential oral anticancer agent acting on telomerase and telomere length. This prospective study evaluated its safety, tolerability, and effectiveness as salvage chemotherapy in patients with advanced biliary tract cancer(BTC) resistant to gemcitabinebased chemotherapy. Methods: Forty-four patients(21 women and 23 men) with advanced BTC and failure history of gemcitabine-based chemotherapy, performance status(PS) 0–2, normal cardiac, hepatic, and renal function were enrolled. Daily dose of KML001(7.5 mg. p.o.) was administered to eligible subjects for 24 weeks divided into six treatment cycles. Response was evaluated bimonthly using CT. Results: After an average of 1.5 months of treatment(range: 0.5–10.0), 3 patients(6.8%) obtained progression-free status, 23 patients(52.3%) had disease progression, and 18 patients(40.9%) dropped out before evaluation. One patient(2.3%) completed six treatment cycles without progression. During the treatment, morphine dosage kept the same or decreased in 20 patients(47.6%). Nine patients(20.5%) experienced grade-3 adverse events(AEs), while no patient experienced grade-4 AEs. The most common AEs were liver enzyme elevation(11/44, 25%) and anemia(10/44, 22.7%). KML001 was discontinued in six patients(13.6%) due to AEs, including liver toxicity( n = 3), QTc prolongation( n = 2), and abdominal pain( n = 1). Conclusions: KML001 did not have enough anticancer effect on patients with advanced BTC resistant to gemcitabine. However, KML001 was safe and well-tolerable in terms of AEs and pain control when used as salvage therapy. Further studies are needed to establish arsenic agents as a reliable treatment option in patients with BTC.

关键词： Biliary tract neoplasms Cholangiocarcinoma Gallbladder neoplasms KML001 Sodium meta-arsenite

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Quantification of HBsAg:Basic virology for clinical practice

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World Journal of gastroenterology 2011年第3期17卷 283-289页

作者： Jung Min Lee Sang Hoon Ahn Department of internal medicine Yonsei University College of Medicine Department of internal medicine Institute of GastroenterologyYonsei University College of Medicine Liver Cirrhosis Clinical Research Center

Hepatitis B surface antigen (HBsAg) is produced and secreted through a complex mechanism that is still not fully understood. In clinical fields, HBsAg has long served as a qualitative diagnostic marker for hepatitis B virus infection. Notably, advances have been made in the development of quantitative HBsAg assays, which have allowed viral replication monitoring, and there is an opportunity to make maximal use of quantitative HBsAg to elucidate its role in clinical fields. Yet, it needs to be underscored that a further understanding of HBsAg, not only from clinical point of view but also from a virologic point of view, would enable us to deepen our insights, so that we could more widely expand and apply its utility. It is also important to be familiar with HBsAg variants and their clinical consequences in terms of immune escape mutants, issues resulting from overlap with corresponding mutation in the P gene, and detection problems for the HBsAg variants. In this article, we review current concepts and issues on the quantification of HBsAg titers with respect to their biologic nature, method principles, and clinically relevant topics.

关键词： Hepatitis B virus Hepatitis B surface antigen Quantitative assay Virology

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Interleukin 12/interleukin 23 pathway: Biological basis and therapeutic effect in patients with Crohn's disease

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World Journal of gastroenterology 2018年第36期24卷 4093-4103页

作者： Ioanna Aggeletopoulou Stelios F Assimakopoulos Christos Konstantakis Christos Triantos Division of gastroenterology Department of Internal MedicineMedical SchoolUniversity of Patras Department of internal medicine University Hospital of Patras

Considering that both innate and adaptive immune responses are involved in the pathogenesis of Crohn's disease(CD), novel therapeutic options have significantly been developed. Biological agents represent an important addition to the conventional treatments for immuno-inflammatory conditions, acting as antagonists of adhesion molecules or various inflammatory cytokines. The interleukin 12(IL-12)/IL-23 common pathway has been found to play a determinant role in the induction of inflammation in adaptive immune responses. In particular, IL-23 promotes the differentiation of na?ve T helper cells into Th17 phenotype with the concomitant secretion of several inflammatory cytokines such as IL-17 and IL-22, whereas IL-12 induces the Th1 polarization and production of critical cytokines such as interferon-γ and tumor necrosis factor. Nowadays, there is increased interest regarding the role of IL-23 as a therapeutic target of CD through the blockage of IL-23 mediated pathways. In this editorial, we focus on the role of IL-12/IL-23 pathway in the regulation of mucosal immunity and in the induction and maintenance of chronic inflammation. In parallel, we critically discuss the available data regarding the therapeutic effect of the IL-12/IL-23 inhibitors and especially of ustekinumab, a human monoclonal antibody which has been recently approved by the United States Food and Drug Administration for the management of moderateto-severe CD and its potential to be used as first-line therapy in everyday clinical practice.

关键词： Crohn’s disease Interleukin 12 Interleukin 23 Monoclonal antibodies Ustekinumab Biological agents Interleukin 12/interleukin 23 blockade

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Checkpoint inhibitors: What gastroenterologists need to know

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World Journal of gastroenterology 2018年第48期24卷 5433-5438页

作者： Monjur Ahmed Division of gastroenterology and Hepatology Department of Internal MedicineThomas Jefferson University

Checkpoint inhibitors are increasingly being used in clinical practice. They can cause various gastrointestinal,hepatic and pancreatic side effects. As these side effects can be serious, appropriate management is essential. The different checkpoint inhibitors with their mechanisms of action and indications, as well as evaluation and management of gastrointestinal, hepatic and pancreatic side effects, are discussed in this article.

关键词： Checkpoint inhibitors Immunotherapy Gastrointestinal management Hepatic and pancreatic side effects

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