Clinicopathological features of autoimmune hepatitis with IgG4-positive plasma cell infiltration
Conclusions: The IgG4-AIH patients had more severe inflammation and advanced fibrosis in the liver. However, their prognosis was not poor compared to that of classical-AIH. IgG4-AIH may have a phenotype distinct from classical-AIH. (Source: Digestive Diseases)
Source: Digestive Diseases - July 30, 2020 Category: Gastroenterology Source Type: research

Features of esophageal adenocarcinoma in magnifying narrow-band imaging
Conclusion: The magnifying endoscopy diagnostic algorithm for gastric cancer may not be useful for esophageal or EGJ adenocarcinomas because of the low visibility of DLs, especially in Siewert type I adenocarcinoma. (Source: Digestive Diseases)
Source: Digestive Diseases - July 30, 2020 Category: Gastroenterology Source Type: research

Comparison study between double bare covered and fully covered metal stent during endoscopic ultrasound-guided choledochoduodenostomy (with video)
Conclusion: DBSEMS can help prevent cholangitis due to stent kinking after EUS-CDS, thus increasing stent patency. (Source: Digestive Diseases)
Source: Digestive Diseases - July 30, 2020 Category: Gastroenterology Source Type: research

Efficacy and feasibility of magnifying blue laser imaging without biopsy confirmation for the diagnosis of the demarcation of gastric tumors: A randomized controlled study
Conclusion: The diagnostic ability of M-BLI is excellent in diagnosing the demarcation of gastric adenoma and well-differentiated adenocarcinoma. biopsy confirmation is not needed for these lesions with a clear DL by M-BLI. (Source: Digestive Diseases)
Source: Digestive Diseases - July 30, 2020 Category: Gastroenterology Source Type: research

Abundance of CD163-Positive Tumor-Associated Macrophages in the Early Gastric Cancer Predicts the Recurrence after Curative Resection
Conclusion: The abundance of CD163+-positive TAMs in EGC predicts the recurrence after curative resection.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - July 28, 2020 Category: Gastroenterology Source Type: research

Improving the Quality of Bowel Preparation: Rewarding Patients for Success or Intensive Patient Education?
Conclusions: Contrasting general beliefs, additional interventions (e.g. incentives or phone consultation) did not improve the quality of the bowel preparation. The unexpected result shows that utilizing extra resources must be balanced against real-world outcomes and may not always provide the expected result.   (Source: Digestive Diseases)
Source: Digestive Diseases - July 27, 2020 Category: Gastroenterology Source Type: research

High-risk comorbidity influences prognosis in early gastric cancer after non-curative endoscopic submucosal dissection: a retrospective study
Conclusion High-risk comorbidity is the primary prognostic parameter in terms of patient factors after non-curative ESD for EGC. The CCI should be considered as a prognostic factor in patients who underwent non-curative ESD for EGC. (Source: Digestive Diseases)
Source: Digestive Diseases - July 14, 2020 Category: Gastroenterology Source Type: research

Predicting the risk of rebleeding after capsule endoscopy in obscure gastrointestinal bleeding - External validation of the RHEMITT Score.
Background and Aims: Prediction of rebleeding after small bowel capsule endoscopy (SBCE) in obscure gastrointestinal bleeding (OGIB) is challenging. The recently described RHEMITT score includes 7 variables: chronic kidney disease (CKD); heart failure (HF); P1/P2 lesions (Saurin's classification); major bleeding; incomplete examination; smoking and endoscopic treatment. This tool has been shown to accurately predict the risk of recurrence after a SBCE study. The primary aim of this study was to perform an external validation of the RHEMITT score. Methods: Retrospective cohort-study, which consecutively included all patien...
Source: Digestive Diseases - July 8, 2020 Category: Gastroenterology Source Type: research

Gastrointestinal Symptoms and Outcomes in Hospitalized Coronavirus Disease 2019 Patients
Discussion: In our study, the presence of GI manifestations in COVID-19 at the time of admission was not associated with increased mortality, LOS, or mechanical ventilation.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 29, 2020 Category: Gastroenterology Source Type: research

Gastrointestinal Symptoms and outcomes in hospitalized COVID-19 patients
Discussion: In our study, the presence of GI mani festations in COVID-19 at the time of admission was not associated with increased mortality, LOS, or mechanical ventilation. (Source: Digestive Diseases)
Source: Digestive Diseases - June 29, 2020 Category: Gastroenterology Source Type: research

Crohn ’s versus cancer – comparison of functional and surgical outcomes after right-sided resections
The objective of this study was to compare functional and surgical outcomes of patients undergoing ileocecal resection for Crohn ’s disease (CD) to patients undergoing oncological right colectomy. Methods Retrospective single center cohort study including consecutive patients undergoing right colectomy for adenocarcinoma (oncological resection) or CD (mesentery-sparing resection) between July 2011 and November 2017. Outcom e measures were pathological details (lymph node yield), postoperative recovery (pain levels, return to flatus and stool, intake of fluids, weight change and mobilization), and early (30-day) outc...
Source: Digestive Diseases - June 29, 2020 Category: Gastroenterology Source Type: research

A case of duodenal tumor adjacent to diverticulum that was resected by technique of partial submucosal injection combined underwater endoscopic mucosal resection
A 66-year-old male was referred to our hospital for treatment of duodenal tumor. The most difficult part was that the lesion was adjacent to duodenal diverticulum. EMR was difficult because submucosal injection quickly spread bloody and makes difficult to visualize of diverticulum edge of the lesion. Simple underwater EMR (UEMR) had risk for perforation at diverticulum part because duodenal diverticulum is spurious diverticulum that defects proper muscle layer. Therefore, to make sufficient distance between diverticulum and the lesion, we performed partial submucosal injection into only diverticulum side of the lesion comb...
Source: Digestive Diseases - June 11, 2020 Category: Gastroenterology Source Type: research

Prevalence, resistance-rates and risk-factors of pathogens in routine bile cultures obtained during endoscopic retrograde cholangiography
Introduction and Objective Acute cholangitis is a life-threatening condition. The early initiation of antibiotic therapy significantly impacts on the course of disease. Only few data are available on distribution and resistance-profiles of bile-pathogens. Here we report on an analysis of routinely acquired bile-specimens and provide an overview of the prevalence, resistance-rates and risk-factors for the presence of pathogens in bile. Methods Bile-cultures obtained from 388 endoscopic retrograde cholangiographies (ERC) with corresponding clinical data were analysed in 208 patients. Results The majority (84.8%) of culture...
Source: Digestive Diseases - June 10, 2020 Category: Gastroenterology Source Type: research

Clinical Outcomes following Endoscopic Treatment for Sporadic Nonampullary Duodenal Adenoma
Conclusions: Favorable long-term outcomes indicate that endoscopic treatment is an effective approach for the treatment of SNDA. Considering the high risk of perforation associated with ESD, APC, or EMR may be an acceptable alternative.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 9, 2020 Category: Gastroenterology Source Type: research

EUS-guided gallbladder drainage using an improved self-expandable covered metal stent with anti-stent migration system (with video)
Conclusion: Although this study has several limitations such as small number of patients and short follow-up period, the re sults show that NEO stents might be suitable as EUS-GBD stents in selected patients. Our results should be validated by a larger prospective, randomized study. (Source: Digestive Diseases)
Source: Digestive Diseases - June 8, 2020 Category: Gastroenterology Source Type: research

Combined healthy lifestyle is inversely associated with upper gastrointestinal disorders among Iranian adults
Conclusion: We found that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults, in a dose-response manner. Individual lifestyle-related factors were also associated with these conditions. (Source: Digestive Diseases)
Source: Digestive Diseases - June 8, 2020 Category: Gastroenterology Source Type: research

Acute Diverticulitis in Elderly Patients: Does Age Really Matter?
Objective: Contrasting results are reported on the clinical course of acute diverticulitis (AD) in the geriatric population. The aim of this study is to compare the AD clinical outcomes between patients aged up to 80 years and those ≥80 years. Methods: A total of 1139 patients were enrolled: 276 patients aged ≥80 years were compared to a group of 863 patients aged (Source: Digestive Diseases)
Source: Digestive Diseases - June 2, 2020 Category: Gastroenterology Source Type: research

Risk factors for adverse events in patients with chronic constipation following lubiprostone administration
Conclusions: Understanding AE risk factors can help avoid unnecessary AEs and promote more effective treatment. (Source: Digestive Diseases)
Source: Digestive Diseases - May 25, 2020 Category: Gastroenterology Source Type: research

A Case of Esophageal Xanthoma with Epithelial Reactive Inflammation with a Characteristic Finding of Narrow-Band Imaging Magnifying Endoscopy
A 75-year-old woman had a 5 mm slightly elevated yellowish lesion in her thoracic esophagus. Narrow-band imaging magnifying endoscopy (NBI-ME) revealed aggregations of a tiny white substance beneath each intrapapillary capillary loop with weaving, dilatation, and a different shape. In this case, an irregular caliber was absent. The biopsy specimen taken from the lesion showed cells with large nuclei and increased chromatin clumping in the basal layer. These cells were positive for p53. Endoscopic submucosal dissection was performed for the purpose of excisional biopsy. Finally, it was diagnosed as an esophageal xanthoma wi...
Source: Digestive Diseases - July 5, 2019 Category: Gastroenterology Source Type: research

Single Nucleotide Polymorphisms in MicroRNA-Binding Site of Epidermal Growth Factor Receptor Signaling Pathway and Susceptibility to Esophageal Squamous Cell Carcinoma
Conclusions: Results of these analyses underline the support of the notion that SNPs in microRNA-binding site of EGFR signaling pathway play certain important roles in the susceptibility to ESCC.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - July 3, 2019 Category: Gastroenterology Source Type: research

Hepatocellular Carcinoma Occurrence/Recurrence after Direct-Acting Antivirals for Hepatitis C in Egyptian Cohort: Single-Center Experience
Conclusions: Although HCC occurrence after DAAs was not high, recurrence was apparently high. Pretreatment alpha-fetoprotein is a predictor for de novo HCC. The time between HCC ablation and DAAs was the strongest predictor of recurrence.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 19, 2019 Category: Gastroenterology Source Type: research

Furosemide Dose Changes Associated with Furosemide/Tolvaptan Combination Therapy in Patients with Cirrhosis
Conclusion: A combination therapy of tolvaptan and furosemide enabled furosemide dose reductions. Systematic reductions of the furosemide doses can lead to the improvement of renal function.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 19, 2019 Category: Gastroenterology Source Type: research

Crohn ’s Disease Patients with Depression Exhibit Alterations in Monocyte/Macrophage Phenotype and Increased Proinflammatory Cytokine Production
Conclusion: Monocytes subpopulation disequilibrium toward intermediate and nonclassic phenotypes and macrophage polarization toward M1 phenotype with increased proinflammatory cytokine release are more likely to be found in CD patients with depressive symptoms.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 19, 2019 Category: Gastroenterology Source Type: research

Cirrhosis Is a Predictor of Adverse Events in Endoscopic Ultrasound Fine-Needle Aspiration: A Propensity-Score Analysis
Conclusions: The rate of AEs after EUS fine-needle aspiration is higher in cirrhotic patients, and acute-on-chronic liver failure may represent a serious complication of this procedure.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 18, 2019 Category: Gastroenterology Source Type: research

Unusual Etiology for Transaminitis
We report the case of a 37-year-old man who presented to the gastroenterology clinic with abdominal pain and was found to have elevated transaminases. Workup for acute/chronic liver disease was unrevealing. He underwent endoscopic evaluation showing a live pinworm in the colon. He was treated with albendazole with improvement in GI symptoms and resolution of his transaminitis. There are scarce reports in the literature describing pathognomonic, clinical, imaging, and laboratory findings for pinworm infection. Here, we attempt to review the literature for hepatic involvement with an enterobius infection and discuss the find...
Source: Digestive Diseases - June 14, 2019 Category: Gastroenterology Source Type: research

Author Index / Subject Index
Dig Dis 2019;37:422 (Source: Digestive Diseases)
Source: Digestive Diseases - June 6, 2019 Category: Gastroenterology Source Type: research

Prelims
Dig Dis 2019;37:343 –346 (Source: Digestive Diseases)
Source: Digestive Diseases - June 6, 2019 Category: Gastroenterology Source Type: research

Hepatic Encephalopathy Aggravated by Systemic Inflammation
Conclusions: The degree of HE and depression correlated with a proinflammatory cytokine pattern. It suggests that beside ammonia elevation, inflammatory cytokines determine occurrence and severity of hepatic encephalopathies. Thus, it can be defined a preferential therapeutic target.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - June 6, 2019 Category: Gastroenterology Source Type: research

Benefit of Pelvic Floor Physical Therapy in Pediatric Patients with Dyssynergic Defecation Constipation
Conclusion: The new field of pediatric PFPT is a safe and effective intervention for children with dyssynergic defecation causing or contributing to chronic constipation, particularly in  children whose comorbidities include anxiety and low ­muscle tone.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 17, 2019 Category: Gastroenterology Source Type: research

Age Affects Clinical Management after Noncurative Endoscopic Submucosal Dissection for Early Gastric Cancer
Conclusions: Despite the fact that almost 80% of super-elderly patients did not undergo additional surgery, the difference of OS between patients with and without additional surgery was not significant only in patients ≥80 years. Therefore, establishment of criteria for selecting treatment methods after noncurative ESD in elderly patients is required.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 17, 2019 Category: Gastroenterology Source Type: research

Pancreatic Solid Focal Lesions: Differential Diagnosis between Autoimmune Pancreatitis and Pancreatic Cancer
Conclusion: Diagnosis of early cancer stages, particularly differentiating AIP from PC can be sometimes problematic. IgG4 levels can be slightly elevated also in case of PC. A targeted biopsy of the pancreas is the method of choice in cases suspected from a focal form of AIP and we recommend to prefer it over other modalities, such as, for example, response to steroid therapy.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 10, 2019 Category: Gastroenterology Source Type: research

Psoriasis and Inflammatory Bowel Disease
Background: Inflammatory bowel disease (IBD) and psoriasis (PS) are associated conditions. The reason for this association lies in the sharing of predisposition genes and common immunological mechanisms.Summary: This review will focus on the interplay between IBD and PS, with details on prevalence and phenotype of PS in IBD, genetics, pathogenetic pathways, and therapy.Key Messages: Microbiome seems relevant in both conditions: a reduction of beneficial bacteria has been observed. IBD and PS have in common some comorbidities like cardiovascular disease, similar risk of cancer and psychiatric problems. Many biological thera...
Source: Digestive Diseases - May 10, 2019 Category: Gastroenterology Source Type: research

Portal Angiogenesis in Chronic Liver Disease Patients Correlates with Portal Pressure and Collateral Formation
Conclusions: Angiogenesis factors correlated with portal pressure and collateral formation and different patterns of circulating angiogenesis mediators were found in peripheral and portal blood of patients with chronic liver disease. These results support the importance of angiogenic pathways in cirrhosis and portal hypertension and highlight areas for further study to identify clinically useful noninvasive markers of portal pressure and collateral formation.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 8, 2019 Category: Gastroenterology Source Type: research

The Diagnosis and Therapy of < b > < i > Helicobacter pylori < /i > < /b > Infection in Hungary: Comparison of Strategies Applied by Family Physicians and Internists
Conclusion: The adherence to the recent recommendations of current guidelines is moderate. There is a need to increase adherence to current recommendations by family physicians and internists.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 8, 2019 Category: Gastroenterology Source Type: research

Relationship between Serum Adalimumab Levels and Clinical Outcome in the Treatment of Inflammatory Bowel Disease
Background: Adalimumab (ADA) is an anti-tumor necrosis factor agent that has been shown to be effective in inducing and maintaining remission in adult patients with inflammatory bowel disease. The relationship between the ADA trough levels and clinical efficacy has been demonstrated, but there is variability in the definition of the most suitable range for its clinical applicability.Summary: A review of published studies during the last 5 years on ADA serum levels and its relationship with the clinical outcome was performed. The studies selected included 7 observational studies, a systematic review, a meta-analysis and a p...
Source: Digestive Diseases - May 5, 2019 Category: Gastroenterology Source Type: research

Fecal Microbiota Transplantation for < b > < i > Clostridium difficile < /i > < /b > Infection: A One-Center Experience
Conclusions: Consistent with some previous reports, we found the following: the source of the donor for FMT did not make a difference in recovery: material from nonrelatives was as effective as from close relatives; and the presence of multiple comorbidities did not make a difference in recovery: patients with 2 or more comorbidities did as well as those with one or none.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 5, 2019 Category: Gastroenterology Source Type: research

Diet and Inflammatory Bowel Disease: Thoughts on Food, Perceptions and Beliefs
Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - May 5, 2019 Category: Gastroenterology Source Type: research

A Surgeon ’s Role in the Management of Early Esophageal, EGJ and Gastric Lesions
Background: Endoscopic mucosal resection and submucosal dissection (ESD) are indicated in a majority of mucosal esophageal, esophagogastric junction and gastric cancers (GC), and selected cases of submucosal cancers as well.Summary: The presence of lymph node metastases in early esophageal cancer (EC) has been proven in up to 50% of ­patients with sm3 cancers treated with surgical resection, and up to 18.5 and 30.5% in sm1 and sm2 cancer respectively. The presence of lymphovascular invasion (LVI), tumor depth #x3e;500 μm and poor tumor differentiation seem to be a common predictor of worse outcomes in literature rep...
Source: Digestive Diseases - April 26, 2019 Category: Gastroenterology Source Type: research

Clinical Profile, Response to Therapy, and Outcome of Children with Primary Intestinal Lymphangiectasia
Conclusion: Presence of chylous ascites suggests severe disease in children with PIL. Majority of PIL children respond to dietary therapy; only 20% need additional therapy. Long-term follow-up is essential to monitor for symptoms relapse and complications.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - April 26, 2019 Category: Gastroenterology Source Type: research

Pancreatic Mass or Cyst? Diagnostic Dilemma
We present a case of a single episode of pancreatitis who underwent EUS for evaluation of possible pancreatic mass leading to a diagnosis of santorinicele and complete pancreatic divisum. We attempt to describe this anomaly, diagnostic approach, and management options.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - April 15, 2019 Category: Gastroenterology Source Type: research

The Rationale and Efficacy of Primary and Secondary Prevention in Adenocarcinomas of the Upper Gastrointestinal Tract
While the primary risk factor for oesophageal adenocarcinoma (OAC) and its precursor lesion Barrett ’s oesophagus (BO) is gastro-oesophageal reflux, the infection withHelicobacter pylori (H. pylori) is the dominant risk factor for gastric cancer. Reduction of reflux by dietary measures and proton pump inhibitors has some merits in OAC prevention, and the chemopreventive effect of Aspirin and statins is being widely investigated; however, improved outcome in OAC occurs primarily as the result of secondary prevention. Early detection of neoplastic lesions in Barrett ’s metaplasia can be achieved by surveillance e...
Source: Digestive Diseases - April 15, 2019 Category: Gastroenterology Source Type: research

Pulley Traction-Assisted Colonic Endoscopic Submucosal Dissection: A Retrospective Case Series
Conclusion: The “pulley” method affords good visibility of the submucosal layer by changing the traction direction in cases that are difficult to manage by conventional traction-assisted ESD.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - April 3, 2019 Category: Gastroenterology Source Type: research

Assessment of Duodenal Adenomas and Strategies for Curative Therapy
Background: The increasing incidence of duodenal neoplasm has underlined different methods of resection depending on the clinical presentation, endoscopic features and histopathology. In this comprehensive review, we systematically describe the current knowledge concerning the diagnosis and management of duodenal adenomas (DAs) and discuss data considering all possible therapeutic approaches.Summary: Among a variety of duodenal lesions, including neuroendocrine tumors and gastrointestinal stromal tumors, DAs present precancerous lesions of the duodenal papilla or non-ampullary region necessitating removal. DAs can occur sp...
Source: Digestive Diseases - March 31, 2019 Category: Gastroenterology Source Type: research

Pancreatic Neuroendocrine Tumours: The Role of Endoscopic Ultrasound Biopsy in Diagnosis and Grading Based on the WHO 2017 Classification
Conclusion: EUS biopsy is an accurate method for the diagnosis and grading of pNETs based on the WHO 2017 Ki-67 labelling scheme.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - March 21, 2019 Category: Gastroenterology Source Type: research

Bowel Preparation for Colonoscopy in Children: 1 Day PEG-3350 with Bisacodyl versus 3 Day Sennosides
Conclusions: The efficacy, safety, and adverse effect profile of 1-day BP with PEG-B regimen was found to be similar to 3-day sennosides regimen, however, the PEG-B regimen had advantages such as short duration, ease of administration, and better patient comfort. Also, high correlation rate between the Boston and Ottawa scales in pediatric patients was remarkable.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - March 7, 2019 Category: Gastroenterology Source Type: research

Appropriate Management of Attenuated Familial Adenomatous Polyposis: Report of a Case and Review of the Literature
We present a case of a 22-year-old female with AFAP who was treated with endoscopic polypectomy and surveilled by annual colonoscopy. Guidelines for AFAP surveillance suggest annual colonoscopy with endoscopic polypectomy in asymptomatic individuals. Indications for immediate surgery include documented or suspected cancer or significant symptoms. Preferred surgical option in AFAP is colectomy and ileo-rectal anastomosis. Surveillance of the AFAP patients should include upper GI endoscopy and duodenoscopy with random biopsies of fundic gland polyps and endoscopic resection of detected adenomas. Annual thyroid ultrasound is ...
Source: Digestive Diseases - March 7, 2019 Category: Gastroenterology Source Type: research

Risk Factors for Low Bone Density in Inflammatory Bowel Disease: Use of Glucocorticoids, Low Body Mass Index, and Smoking
Conclusion: In addition to the generally accepted risk factors for osteoporosis (glucocorticoids, low BMI, smoking), male IBD patients had a trend toward lower BMD. Carrying a mutaticon in NOD2 did not confer a risk for bone loss.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - February 21, 2019 Category: Gastroenterology Source Type: research

Mentality, Career, Mentorship: My Way
Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - February 21, 2019 Category: Gastroenterology Source Type: research

General Aspects of Primary Cancer Prevention
Background: Cancer is the second leading cause of death worldwide next to cardiovascular diseases. Despite the advancement in screening, early diagnosis, and development in treatment technology in last several decades, cancer incidence overall, particularly that of gastrointestinal (GI) cancers, is far from being controlled, and is expected to increase worldwide.Summary: Although numerous preclinical and population-based clinical studies have already made important progress in restraining the overall cancer incidence and mortality, the full potential of preventive strategy is still far from being realized, and remains at a...
Source: Digestive Diseases - February 15, 2019 Category: Gastroenterology Source Type: research

Should Focal Nodular Hyperplasia Still be Operated Upon? Analysis of a Case Series
Conclusion: The present study suggests that it is safe to conservatively manage patients with FNH presumed by highly accurate imaging tests. Similar to hepatic hemangiomas, surgery for FNH should be an exception.Dig Dis (Source: Digestive Diseases)
Source: Digestive Diseases - February 14, 2019 Category: Gastroenterology Source Type: research