{"results":[{"id":"doaj_10.1002/ags3.70074","title":"Development of a Scoring System to Predict the Treatment Success for Nonoperative Management of Peptic Ulcer Perforation: A Secondary Data Analysis of PPAP Study","authors":[{"name":"Kei Ito"},{"name":"Akira Endo"},{"name":"Hiromasa Hoshi"},{"name":"Koji Ito"},{"name":"Tomohiro Akutsu"},{"name":"Hikaru Odera"},{"name":"Hideto Shiraki"},{"name":"Takeshi Yokoyama"},{"name":"Yasukazu Narita"},{"name":"Taro Masuda"},{"name":"Akira Suekane"},{"name":"Shigeru Yamagishi"},{"name":"Koji Morishita"}],"abstract":"ABSTRACT Background Although surgical treatment is the primary measure for patients with perforated peptic ulcer (PPU), nonoperative management (NOM) has become a common alternative. However, risk score models predicting the success of NOM based on the analysis of a large number of patients remain scarce. We developed a clinically applicable scoring system to predict the success of NOM in patients with PPU using data from a large cohort. Method We analyzed data of the Perforated Peptic ulcer Analyzing Project (PPAP), which was a retrospective survey of adult patients with PPU between January 2011 to December 2022. The successful NOM case was defined as patients who survived until hospital discharge without requiring surgery. Factors associated with NOM were identified using a multivariable logistic regression analysis, and a scoring system to predict NOM was developed by weighting these factors based on the regression coefficients. Result Of 702 potentially eligible patients, 584 were treated with NOM, of which 130 patients (22.2%) were treated successfully. Age, sex, body temperature, heart rate, the extent of peritoneal irritation signs, C reactive protein, spread of ascites, and sepsis were included in the final model. Using these variables, we developed the scoring system named PPAP score, which had favorable discriminating ability with the area under receiving operating characteristic curve of 0.799. When the cut‐off was set to 56, the sensitivity and the specificity were 0.738 and 0.722, respectively. Conclusion A predictive scoring model was developed. However, external validation of the model is required to confirm its clinical applicability.","source":"DOAJ","year":2026,"language":"","subjects":["Surgery","Diseases of the digestive system. Gastroenterology"],"doi":"10.1002/ags3.70074","url":"https://doi.org/10.1002/ags3.70074","is_open_access":true,"published_at":"","score":70},{"id":"doaj_10.1186/s12876-025-03638-z","title":"Which scoring systems are useful for predicting the prognosis of lower gastrointestinal bleeding? Old and new","authors":[{"name":"Ku Bean Jeong"},{"name":"Hee Seok Moon"},{"name":"Kyung Ryun In"},{"name":"Sun Hyung Kang"},{"name":"Jae kyu Sung"},{"name":"Hyun Yong Jeong"}],"abstract":"Abstract Background The incidence of lower gastrointestinal bleeding is on the rise, prompting the creation of various scoring systems to forecast patient’s outcomes. But there is no single unified scoring system and these scoring systems clinical data are small and not worldwide. Aims To evaluate how different scoring systems predict mortality and prolonged hospital stay (≥ 10 days). Methods A retrospective review was conducted on the medical records of 4417 patients who presented with hematochezia at the emergency department from January 2016 to December 2022. We evaluated the predictive accuracy of various scoring systems for 30-day mortality and prolonged hospital stay (≥ 10 days) by analyzing the areas under the receiver-operating characteristic curves, taking into account factors such as patient age, laboratory findings, and comorbidities (ABC); AIMS 65; Glasgow-Blatchford; Oakland; Rockall(pre-endoscopy); SHA2PE; and CHAMPS scores. Results We analyzed data from 1000 patients (mean age 66 years, 56.1% men, mean hospital stay 9.4 days) with lower gastrointestinal bleeding confirmed by any other means including DRE, colonoscopy and CT. The 30-day mortality rate was 3.7%. The primary etiologies of lower gastrointestinal bleeding were identified as ischemic colitis and diverticular bleeding, accounting for 18.8% and 18.5% of cases, respectively. In terms of forecasting 30-day mortality, the AIMS 65, CHAMPS, and ABC scoring systems demonstrated superior performance (p \u003c 0.001). For predicting prolonged hospital stay, the SHA2PE score exhibited the highest accuracy among all evaluated systems (p \u003c 0.001). Conclusions The newly developed scoring systems demonstrated superior accuracy in forecasting outcomes for patients with lower gastrointestinal bleeding, and the results of this study demonstrate that these scoring systems can be applied in clinical practice.","source":"DOAJ","year":2025,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1186/s12876-025-03638-z","url":"https://doi.org/10.1186/s12876-025-03638-z","is_open_access":true,"published_at":"","score":69},{"id":"doaj_10.1177/17562848241309870","title":"Ten-day vonoprazan–amoxicillin dual therapy versus 14-day esomeprazole–amoxicillin dual therapy for first-line  eradication: a prospective multicenter randomized controlled trial","authors":[{"name":"Ben-Gang Zhou"},{"name":"Ming-Wen Guo"},{"name":"Li-Juan Zhang"},{"name":"Zhi-Dong Liu"},{"name":"Chun-Hua Liu"},{"name":"Xue-Feng Li"},{"name":"Shun-Song Li"},{"name":"Peng Xiao"},{"name":"Bing Bao"},{"name":"Yao-Wei Ai"},{"name":"Yan-Bing Ding"}],"abstract":"Background: The efficacy of the 14-day esomeprazole–amoxicillin (EA) dual therapy in eradicating Helicobacter pylori ( H. pylori ) has been widely discussed previously. Vonoprazan, a novel potassium-competitive acid blocker, presents rapid, potent, and long-lasting acid inhibitory effects compared to esomeprazole. However, there is currently a scarcity of direct comparisons between the 10-day vonoprazan–amoxicillin (VA) and the 14-day EA dual therapy for H. pylori eradication. Objectives: This study aimed to compare the efficacy and safety of the 10-day VA and the 14-day EA dual therapy for H. pylori first-line eradication. Design: This study was a prospective, multicenter, open-label, randomized controlled trial. Methods: The study was conducted at 10 hospitals in China. In total, 570 newly diagnosed H. pylori -infected patients were recruited from April 2023 to February 2024. These patients were randomly assigned to either the 10-day VA group (vonoprazan 20 mg twice daily + amoxicillin 1000 mg three times daily) or the 14-day EA group (esomeprazole 20 mg four times daily + amoxicillin 750 mg four times daily). The primary outcome was the eradication rate, with secondary outcomes including adverse events and compliance. Results: The 10-day VA regimen outperformed the 14-day EA regimen in terms of eradication rates in intention-to-treat (ITT) analysis (85.4% vs 76.7%, p  = 0.008), modified ITT analysis (90.7% vs 84.8%, p  = 0.036), and per-protocol (PP) analysis (91.1% versus 85.5%, p  = 0.047). The non-inferiority p -values in all three analyses were less than 0.001. No statistically significant difference was observed in the incidence of adverse events between the two groups (9.1% vs 11.7%, p  = 0.308). The 10-day VA regimen demonstrated higher compliance compared to the 14-day EA regimen ( p  = 0.006). Conclusion: The 10-day VA dual therapy showed a satisfactory eradication rate of 91.1% (PP analysis), demonstrating good safety and better compliance compared to the 14-day EA dual therapy as the first-line eradication. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2300070475) on April 12, 2023.","source":"DOAJ","year":2024,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1177/17562848241309870","url":"https://doi.org/10.1177/17562848241309870","is_open_access":true,"published_at":"","score":68},{"id":"doaj_10.1016/j.jhepr.2024.101127","title":"Characteristics and long-term mortality of individuals with MASLD, MetALD, and ALD, and the utility of SAFE score","authors":[{"name":"Pimsiri Sripongpun"},{"name":"Apichat Kaewdech"},{"name":"Prowpanga Udompap"},{"name":"W. Ray Kim"}],"abstract":"Background \u0026amp; Aims: The new nomenclature of steatotic liver disease (SLD) was recently launched with sub-classifications of metabolic dysfunction-associated SLD (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol-related liver disease (ALD). Herein, we aimed to evaluate the characteristics and long-term outcomes associated with these subgroups and the utility of non-invasive biomarkers. Methods: Using NHANES III (the third National Health and Nutrition Examination Survey) and linked mortality data, all adult participants with available ultrasonographic liver steatosis status were included. Those with viral hepatitis, incomplete data on alcohol consumption, cardiometabolic risk, and missing data that hindered Steatosis-associated Fibrosis Estimator (SAFE) score calculation were excluded. The characteristics of those without SLD (no steatosis on ultrasound), MASLD, MetALD, and ALD were compared. Overall survival (OS) was determined and SAFE score strata were applied to SLD subgroups. Results: A total of 9,939 participants were eligible; 64% had no SLD, while 30%, 2.3%, and 1% had MASLD, MetALD, and ALD, respectively. A higher proportion of men, as well as active smokers, was observed in the MetALD and ALD groups compared to the MASLD group. Diabetes was more prevalent in the MASLD group than in the MetALD and ALD groups. The ALD subgroup had significantly lower OS than the MASLD group (p = 0.004), but the MetALD did not (p = 0.165). SAFE score strata meaningfully differentiated OS of all SLD subgroups. Conclusions: MASLD accounted for the largest proportion of SLD. MetALD shared the characteristics of both MASLD and ALD. The ALD subgroup had a significantly lower OS than the MASLD subgroup but there was no difference between MetALD and MASLD. The SAFE score can be used to stratify long-term outcomes in all SLD subgroups. Impact and implications:: “Steatotic liver disease (SLD)” is a recently introduced term covering three subgroups: MASLD (metabolic dysfunction-associated SLD), MetALD (MASLD with increased alcohol intake), and ALD (alcohol-related liver disease). We explored the characteristics and outcomes of these subgroups among the US population. We found that MASLD was far more common than MetALD and ALD, but all subgroups shared cardiometabolic risk factors. The ALD subgroup has the worst survival, pointing to the synergistic effect of alcohol and metabolic dysfunction. In addition, the SAFE (Steatosis-associated Fibrosis Estimator) score might be a useful non-invasive test to stratify long-term risk in all three SLD subgroups.","source":"DOAJ","year":2024,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1016/j.jhepr.2024.101127","url":"http://www.sciencedirect.com/science/article/pii/S2589555924001319","is_open_access":true,"published_at":"","score":68},{"id":"doaj_10.1016/j.vgie.2024.02.008","title":"Functional luminal imaging probe assessment of eosinophilic esophagitis stricture followed by optical-haptic dilation with a dilating cap","authors":[{"name":"Bing Chen, MD"},{"name":"David L. Diehl, MD, FASGE"}],"abstract":"","source":"DOAJ","year":2024,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1016/j.vgie.2024.02.008","url":"http://www.sciencedirect.com/science/article/pii/S2468448124000304","is_open_access":true,"published_at":"","score":68},{"id":"crossref_10.1002/ueg2.12297","title":"Digestive diseases: Big burden, low funding? Results of the new United European Gastroenterology White Book on digestive diseases","authors":[{"name":"Luigi Ricciardiello"}],"abstract":"","source":"CrossRef","year":2022,"language":"en","subjects":null,"doi":"10.1002/ueg2.12297","url":"https://doi.org/10.1002/ueg2.12297","pdf_url":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/ueg2.12297","is_open_access":true,"citations":11,"published_at":"","score":66.33},{"id":"doaj_10.22516/25007440.762","title":"Disseminated abdominal echinococcosis: Case report","authors":[{"name":"Gabriela Evers S"},{"name":"Héctor Adolfo Polania Liscano"},{"name":"Santiago  Adolfo Polania Galindo"}],"abstract":"\nWe describe a case of disseminated abdominal hydatid disease in a 21-year-old man who presented with clinical symptoms of persistent abdominal pain after abscess drainage post-appendectomy. The images showed multiple cystic lesions in the peritoneum, liver, and spleen. Due to pain exacerbation, the patient was taken to laparotomy. Multiple cystic lesions scattered throughout the abdominal cavity were observed, which were diagnosed by histopathology as multiple cystic lesions due to peritoneal and abdominal echinococcosis.\n","source":"DOAJ","year":2022,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.22516/25007440.762","url":"https://revistagastrocol.com/index.php/rcg/article/view/762","is_open_access":true,"published_at":"","score":66},{"id":"doaj_10.1002/jgh3.12789","title":"Cumulative risk of developing a new symptom in patients with primary biliary cholangitis and its impact on prognosis","authors":[{"name":"Naruhiro Kimura"},{"name":"Toru Setsu"},{"name":"Yoshihisa Arao"},{"name":"Norihiro Sakai"},{"name":"Yusuke Watanabe"},{"name":"Hiroyuki Abe"},{"name":"Hiroteru Kamimura"},{"name":"Akira Sakamaki"},{"name":"Takeshi Yokoo"},{"name":"Kenya Kamimura"},{"name":"Atsunori Tsuchiya"},{"name":"Akihiko Osaki"},{"name":"Kentarou Igarashi"},{"name":"Nobuo Waguri"},{"name":"Masahiko Yanagi"},{"name":"Toru Takahashi"},{"name":"Soichi Sugitani"},{"name":"Yuka Kobayashi"},{"name":"Masaaki Takamura"},{"name":"Akira Yoshikawa"},{"name":"Toru Ishikawa"},{"name":"Toshiaki Yoshida"},{"name":"Toshiaki Watanabe"},{"name":"Hitoshi Bannai"},{"name":"Tomoyuki Kubota"},{"name":"Kazuhiro Funakoshi"},{"name":"Hiroto Wakabayashi"},{"name":"So Kurita"},{"name":"Norio Ogata"},{"name":"Masashi Watanabe"},{"name":"Yuhsaku Mita"},{"name":"Shigeki Mori"},{"name":"Motoya Sugiyama"},{"name":"Toru Miyajima"},{"name":"Sumio Takahashi"},{"name":"Shuichi Sato"},{"name":"Kisei Ishizuka"},{"name":"Hironobu Ohta"},{"name":"Yutaka Aoyagi"},{"name":"Shuji Terai"}],"abstract":"Abstract Background and Aim Symptoms of primary biliary cholangitis (PBC) frequently impair one's quality of life (QOL). Nonetheless, with improved treatment, the prognosis of PBC also improves. QOL plays an important role in patients with PBC. In this study, we aimed to reevaluate the transition of new symptom development in PBC and its predictive factors. Methods This retrospective multicenter study enrolled 382 patients with PBC for symptom analysis. The impact of a newly developed symptom on PBC prognosis was investigated by Kaplan–Meier analysis with propensity score matching and logistic progression analysis. Results The cumulative risk of developing a new symptom after 10 and 20 years of follow‐up was 7.6 and 28.2%, and specifically that of pruritus, which was the most common symptom, was 6.7 and 23.3%, respectively. In Cox hazard risk analysis, serum Alb level (hazard ratio [HR], 1.097; 95% confidence interval [CI], 1.033–1.165; P = 0.002), the serum D‐Bil level (HR, 6.262; 95% CI, 2.522–15.553, P \u003c 0.001), and Paris II criteria (HR, 0.435; 95% CI, 0.183–1.036; P = 0.037) were significant independent predictors of a new symptom. Kaplan–Meier analysis showed that the overall survival and liver‐related death were not significant between patients with and without a new symptom. Conclusion The cumulative risk of new symptom development is roughly 30% 20 years after diagnosis and could be predicted by factors including serum albumin levels, serum D‐Bil level, and Paris II criteria.","source":"DOAJ","year":2022,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1002/jgh3.12789","url":"https://doi.org/10.1002/jgh3.12789","is_open_access":true,"published_at":"","score":66},{"id":"doaj_10.1080/19490976.2022.2108281","title":"A single cell survey of the microbial impacts on the mouse small intestinal epithelium","authors":[{"name":"Derek K.L. Tsang"},{"name":"Ryan J. Wang"},{"name":"Oliver De Sa"},{"name":"Arshad Ayyaz"},{"name":"Elisabeth G. Foerster"},{"name":"Giuliano Bayer"},{"name":"Shawn Goyal"},{"name":"Daniel Trcka"},{"name":"Bibaswan Ghoshal"},{"name":"Jeffrey L. Wrana"},{"name":"Stephen E. Girardin"},{"name":"Dana J. Philpott"}],"abstract":"The small intestinal epithelial barrier inputs signals from the gut microbiota in order to balance physiological inflammation and tolerance, and to promote homeostasis. Understanding the dynamic relationship between microbes and intestinal epithelial cells has been a challenge given the cellular heterogeneity associated with the epithelium and the inherent difficulty of isolating and identifying individual cell types. Here, we used single-cell RNA sequencing of small intestinal epithelial cells from germ-free and specific pathogen-free mice to study microbe-epithelium crosstalk at the single-cell resolution. The presence of microbiota did not impact overall cellular composition of the epithelium, except for an increase in Paneth cell numbers. Contrary to expectations, pattern recognition receptors and their adaptors were not induced by the microbiota but showed concentrated expression in a small proportion of epithelial cell subsets. The presence of the microbiota induced the expression of host defense- and glycosylation-associated genes in distinct epithelial cell compartments. Moreover, the microbiota altered the metabolic gene expression profile of epithelial cells, consequently inducing mTOR signaling thereby suggesting microbe-derived metabolites directly activate and regulate mTOR signaling. Altogether, these findings present a resource of the homeostatic transcriptional and cellular impact of the microbiota on the small intestinal epithelium.","source":"DOAJ","year":2022,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1080/19490976.2022.2108281","url":"https://www.tandfonline.com/doi/10.1080/19490976.2022.2108281","is_open_access":true,"published_at":"","score":66},{"id":"doaj_10.1155/2021/9920981","title":"Diarrhea due to SARS-CoV-2-Related Exocrine Pancreatic Insufficiency","authors":[{"name":"Harish K. Patel"},{"name":"Jasbir Makker"},{"name":"Ahemd Alemam"},{"name":"Sridhar Chilimuri"}],"abstract":"Gastrointestinal symptoms, especially diarrhea, are common with novel coronavirus SARS-CoV-2 infection. Angiotensin-converting enzyme-2 (ACE-2) receptors are heavily expressed in enterocytes and serve as entry receptors for SARS-CoV-2. ACE-2 receptors may also be responsible for pancreatic injury in patients infected with SARS-CoV-2. Diarrhea associated with SARS-CoV-2 is usually believed to be due to viral invasion of enterocytes. However, exocrine pancreatic insufficiency resulting from SARS-CoV-2 is another plausible mechanism leading to diarrhea in such patients. We present a case series of three SARS-CoV-2-infected patients with predominant respiratory symptoms at presentation who developed diarrhea, and further fecal analysis revealed exocrine pancreatic insufficiency as the underlying mechanism.","source":"DOAJ","year":2021,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1155/2021/9920981","url":"http://dx.doi.org/10.1155/2021/9920981","is_open_access":true,"published_at":"","score":65},{"id":"doaj_10.1002/hep4.1229","title":"Lymphoid Enhancer Factor 1 Contributes to Hepatocellular Carcinoma Progression Through Transcriptional Regulation of Epithelial‐Mesenchymal Transition Regulators and Stemness Genes","authors":[{"name":"Chih‐Li Chen"},{"name":"Yu‐Shuen Tsai"},{"name":"Yen‐Hua Huang"},{"name":"Yuh‐Jin Liang"},{"name":"Ya‐Yun Sun"},{"name":"Chien‐Wei Su"},{"name":"Gar‐Yang Chau"},{"name":"Yi‐Chen Yeh"},{"name":"Yung‐Sheng Chang"},{"name":"Jui‐Ting Hu"},{"name":"Jaw‐Ching Wu"}],"abstract":"Lymphoid enhancer factor 1 (LEF1) activity is associated with progression of several types of cancers. The role of LEF1 in progression of hepatocellular carcinoma (HCC) remains poorly known. We investigated LEF1 expression in HCC and its interactions with epithelial‐mesenchymal transition (EMT) regulators (e.g., Snail, Slug, Twist) and stemness genes (e.g., octamer‐binding transcription factor 4 [Oct4], sex determining region Y‐box 2 [Sox2], Nanog homeobox [Nanog]). Microarray analysis was performed on resected tumor samples from patients with HCC with or without postoperative recurrence. LEF1 expression was associated with postoperative recurrence as validated by immunohistochemical staining in another HCC cohort. Among 74 patients, 44 displayed a relatively high percentage of LEF1 staining (\u003e30% of HCC cells), which was associated with a reduced recurrence‐free interval (P \u003c 0.001) and overall survival (P = 0.009). In multivariate analysis, a high percentage of LEF1 staining was significantly associated with low albumin level (P = 0.035), Twist overexpression (P = 0.018), Snail overexpression (P = 0.064), co‐expression of Twist and Snail (P = 0.054), and multinodular tumors (P = 0.025). Down‐regulation of LEF1 by short hairpin RNA decreased tumor sphere formation, soft agar colony formation, and transwell invasiveness of HCC cell lines Mahlavu and PLC. Xenotransplant and tail vein injection experiments revealed that LEF1 down‐regulation in Mahlavu reduced tumor size and metastasis. LEF1 up‐regulation in Huh7 increased sphere formation, soft agar colony formation, and transwell invasiveness. LEF1 was shown to physically interact with and transcriptionally activate promoter regions of Oct4, Snail, Slug, and Twist. Furthermore, Oct4, Snail, and Twist transactivated LEF1 to form a regulatory positive‐feedback loop. Conclusion: LEF1 plays a pivotal role in HCC progression through transcriptional regulation of Oct4 and EMT regulators.","source":"DOAJ","year":2018,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1002/hep4.1229","url":"https://doi.org/10.1002/hep4.1229","is_open_access":true,"published_at":"","score":62},{"id":"doaj_Challenging+hepatitis+C-infected+liver+transplant+patients","title":"Challenging hepatitis C-infected liver transplant patients","authors":[{"name":"Oliver M"},{"name":"Chiodo Ortiz C"},{"name":"Ortiz J"}],"abstract":"Madeleine Oliver,1 Christopher Chiodo Ortiz,2 Jorge Ortiz31University of Toledo College of Medicine, Toledo, OH, 2Bucknell University, Lewisburg, PA, 3Department of Transplant Surgery, University of Toledo Medical Center, Toledo, OH, USA  Abstract: Caring for liver transplant patients suffering from chronic hepatitis C virus (HCV) infection is a challenging task for transplant surgeons and primary physicians alike. HCV is the leading cause of liver transplantation in the USA and comes with a myriad of complications that increase morbidity and mortality. This review focuses on patient follow-up, spanning from before the liver transplant occurs to the patient\u0026#39;s long-term health. Pretransplant, both donor and recipient variables, must be carefully chosen to ensure optimal surgical success. Risk factors must be identified and HCV viral load must be reduced to a minimum. In addition to standard transplant complications, HCV patients suffer from additional problems, such as fibrosing cholestatic hepatitis and widespread viremia. Physicians must focus on the balance of immunosuppressive and antiviral medications, while considering possible side effects from these potent drugs. Over the years following surgery, physicians must identify any signs of failing liver health, as HCV-positive patients have an increased risk for cirrhosis and certain life-threatening malignancies.  Keywords: liver transplant, hepatitis C virus, postoperative, cirrhosis, donor and recipient variables, viremia","source":"DOAJ","year":2016,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"url":"https://www.dovepress.com/challenging-hepatitis-c-infected-liver-transplant-patients-peer-reviewed-article-HMER","is_open_access":true,"published_at":"","score":60},{"id":"doaj_10.4103/2230-8210.176349","title":"Association between glycemic control and morning blood surge with vascular endothelial dysfunction in type 2 diabetes mellitus patients","authors":[{"name":"Rama Kumari Nuthalapati"},{"name":"Bhaskara Raju Indukuri"}],"abstract":"Objective: Morning blood pressure surge (MBPS) is an independent predictor of cardiovascular events. However, little is known about the association between glycemic control and MBPS, and its effect on vascular injury in patients with type 2 diabetes mellitus (T2DM). The current study examined the association between glycemic control and MBPS and the involvement of MBPS in the development of vascular dysfunction in T2DM patients. Materials and Methods: One hundred and twenty-two consecutive T2DM outpatients from the Department of Cardiology and Endocrinology were enrolled in this study. We did MBPS in T2DM patients, 85 (male) (69.7%) patients and 37 (female) patients (30.3%); mean age 60.1 ± 9.39; (n = 122) using 24 h ambulatory blood pressure monitoring and assessed vascular function by brachial artery flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD). Results: The correlation between MBPS and various clinical variables were examined by single regression analysis in all subjects. MBPS showed significant and positive correlation with pulse rate (P = 0.01), fasting blood sugar (P = 0.002), and postprandial blood sugar (P = 0.05). To further confirm the association of insulin resistance (IR) with MBPS in T2DM patients, we examined the correlation between homeostasis model assessment-IR (HOMA-IR), an established marker of IR and MBPS in diabetic (DM) patients who were not taking insulin no significant association with MBPS in T2DM patients (P = 0.41), angiotensin-converting enzyme/angiotensin receptor blocker (P = 0.07). We examined the relationship between MBPS and vascular injury by measuring endothelium-dependent FMD and endothelium-independent NMD in T2DM patients. Among the various traditional risk factors for atherosclerosis such as DM duration (P = 0.04), platelet reactivity (P = 0.04) and morning surge (P = 0.002) emerged as significant factors. HOMA-IR was a negative correlation with FMD. Conclusions: The current study demonstrated that poor glycemic control and IR have predictive value for the occurrence of MBPS in T2DM patients, which might be significantly associated with endothelial dysfunction.","source":"DOAJ","year":2016,"language":"","subjects":["Diseases of the endocrine glands. Clinical endocrinology","Diseases of the digestive system. Gastroenterology"],"doi":"10.4103/2230-8210.176349","url":"http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=2;spage=182;epage=188;aulast=Nuthalapati","is_open_access":true,"published_at":"","score":60},{"id":"doaj_10.1055/s-0042-103417","title":"Stent for Crohn’s disease strictures: Which one and when?","authors":[{"name":"Alain Attar"}],"abstract":"","source":"DOAJ","year":2016,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1055/s-0042-103417","url":"http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-103417","is_open_access":true,"published_at":"","score":60},{"id":"doaj_10.1155/2014/837860","title":"Appendiceal Diverticulitis Clinically Masquerading as an Appendiceal Carcinoma","authors":[{"name":"Tadashi Terada"}],"abstract":"Appendiceal diverticulosis is a rare condition. Herein reported is a case of appendiceal diverticulosis and diverticulitis clinically masquerading as appendiceal carcinoma. A 62-year-old woman presented with abdominal pain. US and CT showed a tumor measuring 5 × 4 × 4 cm in vermiform appendix. Colon endoscopy showed mucosal elevation and irregularity in the orifice of vermiform appendix. A biopsy of the appendiceal mucosa showed no significant changes. Clinical diagnosis was appendiceal carcinoma and wide excision of terminal ileum, appendix, cecum, and ascending colon was performed. Grossly, the appendix showed a tumor measuring 5 × 3 × 4 cm. The appendiceal lumen was opened, and the appendiceal mucosa was elevated and irregular. The periappendiceal tissue showed thickening. Microscopically, the lesion was multiple appendiceal diverticula. The diverticula were penetrating the muscle layer. The mucosa showed erosions in places. Much fibrosis, abscess formations, and lymphocytic infiltration were seen in the subserosa. Abscesses were also seen in the diverticular lumens. Some diverticula penetrated into the subserosa. The pathologic diagnosis was appendiceal diverticulitis. When they encounter an appendiceal mass, clinicians should consider appendiceal diverticulitis as a differential diagnosis.","source":"DOAJ","year":2014,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1155/2014/837860","url":"http://dx.doi.org/10.1155/2014/837860","is_open_access":true,"published_at":"","score":58},{"id":"doaj_10.4318/tjg.2013.0697","title":"A retrospective review of patients with non-traumatic spontaneous intramural hematoma","authors":[{"name":"Fatih ALTINTOPRAK"},{"name":"Enis DİKİCİER"},{"name":"Muhammed AKYÜZ"},{"name":"Uğur DEVECİ"},{"name":"Yusuf ARSLAN"},{"name":"Yasemin GÜNDÜZ"},{"name":"Murat YÜCEL"},{"name":"Osman Nuri DİLEK"}],"abstract":"","source":"DOAJ","year":2013,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.4318/tjg.2013.0697","url":"https://turkjgastroenterol.org/index.php/tjg/article/view/2284","is_open_access":true,"published_at":"","score":57},{"id":"crossref_10.1053/j.gastro.2012.10.012","title":"Funding for Research in Digestive Diseases by NIH and NIDDK","authors":[{"name":"Stephen P. James"}],"abstract":"","source":"CrossRef","year":2012,"language":"en","subjects":null,"doi":"10.1053/j.gastro.2012.10.012","url":"https://doi.org/10.1053/j.gastro.2012.10.012","is_open_access":true,"citations":2,"published_at":"","score":56.06},{"id":"doaj_Soluci%C3%B3n+del+caso%3A+Anemia+y+dolor+c%C3%B3lico+hipog%C3%A1strico+de+meses+de+evoluci%C3%B3n","title":"Solución del caso: Anemia y dolor cólico hipogástrico de meses de evolución","authors":null,"abstract":"","source":"DOAJ","year":2012,"language":"","subjects":["Diseases of the digestive system. Gastroenterology","Medicine"],"url":"http://www.redalyc.org/articulo.oa?id=199326833009","pdf_url":"http://www.redalyc.org/articulo.oa?id=199326833009","is_open_access":true,"published_at":"","score":56},{"id":"doaj_10.1186/1471-230X-11-121","title":"The impact of laxative use upon symptoms in patients with proven slow transit constipation","authors":[{"name":"Dinning Phil G"},{"name":"Hunt Linda"},{"name":"Lubowski David Z"},{"name":"Kalantar Jamshid S"},{"name":"Cook Ian J"},{"name":"Jones Mike P"}],"abstract":"\u003cp\u003eAbstract\u003c/p\u003e \u003cp\u003eBackground\u003c/p\u003e \u003cp\u003eConstipation severity is often defined by symptoms including feelings of complete evacuation, straining, stool frequency and consistency. These descriptors are mostly obtained in the absence of laxative use. For many constipated patients laxative usage is ubiquitous and long standing. Our aim was to determine the impact of laxative use upon the stereotypic constipation descriptors.\u003c/p\u003e \u003cp\u003eMethods\u003c/p\u003e \u003cp\u003ePatients with confirmed slow transit constipation completed 3-week stool diaries, detailing stool frequency and form, straining, laxative use and pain and bloating scores. Each diary day was classified as being under laxative affect (laxative affected days) or not (laxative unaffected days). Unconditional logistic regression was used to assess the affects of laxatives on constipation symptoms.\u003c/p\u003e \u003cp\u003eResults\u003c/p\u003e \u003cp\u003eNinety four patients with scintigraphically confirmed slow transit constipation were enrolled in the study. These patients reported a stool frequency of 5.6 ± 4.3 bowel motions/week, only 21 patients reported \u003c3 bowel motions/week. Similarly, 21 patients reported a predominant hard stool at defecation. The majority (90%) of patients reported regular straining. A regular feeling of complete evacuation was reported in just 7 patients. Daily pain and/or bloating were reported by 92% of patients. When compared with laxative unaffected days, on the laxative affected days patients had a higher stool frequency (OR 2.23; \u003cit\u003eP \u003c/it\u003e\u003c0.001) and were more likely to report loose stools (OR 1.64; \u003cit\u003eP \u003c/it\u003e\u003c0.009). Laxatives did not increase the number of bowel actions associated with a feeling of complete evacuation. Laxative use had no affect upon straining, pain or bloating scores\u003c/p\u003e \u003cp\u003eConclusions\u003c/p\u003e \u003cp\u003eThe reporting of frequent and loose stools with abdominal pain and/or bloating is common in patients with slow transit constipation. While laxative use is a significant contributor to altering stool frequency and form, laxatives have no apparent affect on pain or bloating or upon a patients feeling of complete evacuation. These factors need to be taken into account when using constipation symptoms to define this population.\u003c/p\u003e","source":"DOAJ","year":2011,"language":"","subjects":["Diseases of the digestive system. Gastroenterology"],"doi":"10.1186/1471-230X-11-121","url":"http://www.biomedcentral.com/1471-230X/11/121","is_open_access":true,"published_at":"","score":55},{"id":"crossref_10.1053/j.gastro.2011.10.013","title":"Free Radical Biology in Digestive Diseases","authors":[{"name":"Gavin E. Arteel"}],"abstract":"","source":"CrossRef","year":2011,"language":"en","subjects":null,"doi":"10.1053/j.gastro.2011.10.013","url":"https://doi.org/10.1053/j.gastro.2011.10.013","is_open_access":true,"published_at":"","score":55}],"total":5326607,"page":1,"page_size":20,"sources":["DOAJ","CrossRef"],"query":"Diseases of the digestive system. Gastroenterology"}