Interaction of human gut microbiota and local immune system in progression of colorectal adenoma (MIMICA-1): a protocol for a prospective, observational cohort study.

Introduction: The current understanding of colorectal carcinogenesis is based on the adenoma-carcinoma sequence, where genetics, intestinal microbiota changes and local immunity shifts seem to play the key roles. Despite the emerging evidence of dysbiotic intestinal state and immune-cell infiltration changes in patients with colorectal adenocarcinoma, early and advanced adenoma as precursors of colorectal cancer, and carcinoma as the following progression, are rather less studied. The newly colon-site adapted AI-based analysis of immune infiltrates is able to predict long-term outcomes of colon carcinoma.

Aurora kinase A promotes hepatic stellate cell activation and liver fibrosis through the Wnt/β-catenin pathway.

Aims: Aurora kinase A (AURKA) has been implicated in promoting myeloid and renal fibrosis. This study aimed to investigate the impact and underlying mechanism of AURKA on liver fibrosis and to assess the therapeutic potential of MLN8237, a small-molecule AURKA inhibitor, in preventing liver fibrosis in mice.

Methods: The research used bioinformatics analysis and immunohistochemistry staining on fibrotic liver tissues from human and mouse models to assess AURKA expression.

Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy.

Aim: We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.

Methods: We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.

Comparative Study of Remimazolam and Midazolam During Sedated Upper Gastrointestinal Endoscopy: A Propensity Score Matching Analysis.

Aim: This study aimed to compare the use of remimazolam and midazolam in upper gastrointestinal endoscopy in Japan as a sub-analysis of data from an investigator-initiated clinical trial of remimazolam.

Methods And Results: Patients in two groups were matched using propensity score matching. We evaluated the time from the end of the gastrointestinal endoscopy until discharge, the time from the end of the procedure until awakening, and adverse events.

Effect of a Ketogenic Diet on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Progression: A Randomized Controlled Trial.

Background: Despite the popularity of a ketogenic diet, no randomized, controlled trials have evaluated its efficacy on metabolic dysfunction-associated steatotic liver disease (MASLD) progression.

Methods: We conducted an 8-week, open-label, randomized controlled trial involving 24 patients with MASLD who were randomly assigned to either the home delivery ketogenic diet or a nutrition education program on adherence to the DASH diet. The primary outcome was a reduction in hepatic steatosis as measured by transient elastography.

Efficacy of 2-Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial.

Background And Aim: Oxidative stress has been considered a factor in the development of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The present clinical trial evaluated whether adding intravenous mesna to rectal indomethacin could prevent or alleviate PEP.

Methods: An open-labeled clinical trial was done on 698 participants undergoing endoscopic retrograde cholangiopancreatography (ERCP).

Potent human antibodies against SpA5 identified by high-throughput single-cell sequencing of phase I clinical volunteers' B cells.

The drug resistance problem of needs to be solved urgently. Here, we report the rapid identification of human antibodies by high-throughput single-cell RNA and VDJ sequencing of memory B cells derived from 64 volunteers immunized with recombinant five-component vaccine (clinical phase I). From 676 antigen-binding IgG1 clonotypes, TOP10 sequences were selected for expression and characterization, with the most potent one, Abs-9, having nanomolar affinity for the pentameric form of the specific antigen protein A.

Revealing the role of cancer-associated fibroblast senescence in prognosis and immune landscape in pancreatic cancer.

Cancer-associated fibroblasts (CAFs) represent a major contributor to tumor growth. Cellular senescence is a state of cell-cycle arrest characterized by a pro-inflammatory phenotype. The potential impact of CAF senescence on tumor progression and the tumor microenvironment (TME) remains to be elucidated.

Drug-induced urinary retention: a real-world pharmacovigilance study using FDA and Canada vigilance databases.

Background: Urinary retention (UR) is a clinical condition where patients cannot fully empty their bladder. Although numerous drugs are associated with UR, comprehensive and reliable studies identifying drugs that induce UR are scarce.

Methods: This study leveraged data from the FDA Adverse Event Reporting System (FAERS) and the Canadian Vigilance Adverse Reaction (CVAR) database to explore adverse events (AEs) related to UR from 2004 to Q1 2024.

Understanding Predictors of Crohn's Disease: Determinants of Altered Barrier Function in Pre-Disease Phase of Crohn's Disease.

The pathogenesis of Crohn's disease (CD) remains unknown. The current working theory is that genetic susceptibility influences host-microbe interactions, resulting in chronic inflammation. Case-control studies fail to explain the triggers or pathogenesis of the disease, notably due to confounding factors in patients with established disease.

Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy.

Patients with severe alcoholic hepatitis SAH may suffer of undiagnosed psychiatric illnesses, typically depression. Assessment of prevalence and potential impact of psychiatric disturbances on alcohol relapse after LT, were the main objectives of this study. One hundred consecutive patients with SAH from April 2016 to May 2023 were analyzed.

Successful Treatment of Refractory Ulcerative Colitis With 5-Aminosalicylic Acid Intolerance and Biologic Therapy Resistance Using Combined Granulocyte and Monocyte Adsorptive Apheresis.

We report the case of a 37-year-old male patient diagnosed with moderate left-sided ulcerative colitis (UC). Initial therapy with 5-aminosalicylic acid (5-ASA) was terminated within days due to exacerbation of symptoms, leading to a diagnosis of 5-ASA intolerance. Although induction of remission was achieved with prednisolone, the patient developed steroid dependency.

Branched-Chain Amino Acid Supplements for Sarcopenia in Liver Cirrhosis: A Systematic Review and Meta-analysis.

Background: Sarcopenia, a key aspect of malnutrition in liver cirrhosis (LC), affects 30-70% of LC patients. Given the inconsistent results from RCTs on branched-chain amino acids (BCAAs) for treating sarcopenia in LC, we conducted a systematic review and meta-analysis to assess the efficacy and safety of BCAAs for sarcopenia management in LC patients.

Methods: A systematic review and meta-analysis synthesizing evidence from RCTs obtained from PubMed, Embase, Cochrane, Scopus, and Web of Science from inception to April 2024.

The Role of Ursodeoxycholic Acid Administration During the COVID-19 Pandemic: A Questionnaire Survey.

In December 2022, China classified COVID-19 as a category B infectious disease. This ended 2 years of close epidemiological surveillance of COVID-19. The objective of this questionnaire was to assess the infection status in the COVID-19 pandemic since December in Henan Province, China, and the prevalence of infection in people who were taking ursodeoxycholic acid (UDCA) during this period.

Evidence summary of lifestyle interventions in adults with metabolic dysfunction-associated steatotic liver disease.

Objective: In this study, our objective was to provide practice recommendations by thoroughly examining lifestyle interventions for adults diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD). This was achieved through a systematic review of the literature, specifically focusing on lifestyle modification interventions in adults with MASLD.

Methods: The PIPOST (Population, Intervention, Professional, Outcome, Setting, and Type of evidence) framework was used to identify the questions for summarizing evidence.

Pharyngeal perforations after anterior cervical spinal procedures: A systematic review.

Background: Digestive system perforations after anterior cervical spine surgery (ACSS), if left untreated, are life-threatening. These injuries are often categorized as pharyngoesophageal. Although the pharynx and esophagus are continuations of each other, they are two distinct anatomical structures.

The role of the extracellular matrix in cardiac regeneration.

The extracellular matrix (ECM) is a complex and dynamic three-dimensional network that functions as an architectural scaffold to maintain cardiac homeostasis. Important biochemical and mechanical signals associated with cell‒cell communication are provided via the reciprocal interaction between cells and the ECM. By converting mechanical cues into biochemical signals, the ECM regulates many cell processes, including migration, adhesion, growth, differentiation, proliferation, and apoptosis.

Dysplasia and Colorectal Cancer Surveillance in Ulcerative Colitis Patients in Latin America: Real-World Data.

Background: The prevalence of colorectal cancer (CRC) in patients with ulcerative colitis (UC) is higher than in the general population, in Latin America there is a progressive increase of UC, and information about CRC screening in inflammatory bowel disease (IBD) is scarce. The aim of this study was to analyze the findings of endoscopic surveillance of CRC in patients with IBD according to available technology.

Methods: Multicenter, cross-sectional, analytical study conducted in Latin American countries, in patients with UC, predominantly with more than 8 years of diagnosis and different degrees of disease activity.

Intravenous Steroids Do Not Improve Short-Term Outcomes of Patients With Crohn's Disease Presenting With an Acute Small Bowel Obstruction.

Background: Intravenous (IV) steroids are commonly used to treat acute flares of Crohn's disease (CD). However, it is unclear if they are beneficial in the setting of uncomplicated small bowel obstruction (SBO). We sought to examine if IV steroid administration improved short-term outcomes in patients with CD hospitalized for acute, uncomplicated SBO across three New York City hospital systems.

Predictive performance of noninvasive factors for liver fibrosis in severe obesity: a screening based on machine learning models.

Objectives: Liver fibrosis resulting from nonalcoholic fatty liver disease (NAFLD) and metabolic disorders is highly prevalent in patients with severe obesity and poses a significant health challenge. However, there is a lack of data on the effectiveness of noninvasive factors in predicting liver fibrosis. Therefore, this study aimed to assess the relationship between these factors and liver fibrosis through a machine learning approach.

Liver transplantation for cirrhosis and its complications.

Objectives: To review the current indications for liver transplantation (LT) in cirrhosis, including evolving criteria for hepatocellular carcinoma (HCC) and other malignancies, how donor organ allocation is established, and to address challenges of long-term complications post-transplantation.

Methods: A comprehensive review of the literature was conducted to evaluate advancements in LT indications, pretransplant evaluation protocols, organ allocation strategies, and management approaches for long-term post-transplant complications.

Results: Liver transplantation remains the definitive treatment for cirrhosis and offers substantial survival benefits for patients with early-stage HCC.

Liver transplantation for colorectal cancer with liver metastases.

Over the last decade, multiple clinical trials have demonstrated a survival benefit for liver transplantation in colorectal cancer with liver metastases. Additionally, advances in donor organ preservation have expanded organ availability affording the opportunity to expand indications for liver transplantation, such as colorectal cancer with unresectable liver metastases. Current data support comparable overall survival (OS) for liver transplantation for colorectal cancer with liver metastases compared with general liver transplantation recipients.

A New Routine Immunity Score (RIS2020) to Predict Severe Infection in Solid-Organ Transplant Recipients.

BACKGROUND Infection is a cause of morbidity and mortality in solid-organ transplantation (SOT). We evaluated a new score that is applied during the first month after transplantation. The score comprises biomarkers of innate and acquired immunity to predict infections in SOT.

Verification in an animal study of the appropriate settings for a novel radiofrequency generator in radiofrequency ablation therapy for residual intraductal lesions after endoscopic papillectomy (with video).

Endoscopic intraductal radiofrequency ablation (ID-RFA) can curatively treat residual intraductal lesions after endoscopic papillectomy. This study aimed to verify the tissue invasiveness of ID-RFA using a novel RF generator and to explore its appropriate settings in an animal experiment, followed by a small clinical study. Pig liver specimens were ablated using a dedicated RF catheter and two RF generators to investigate structural differences between them and the ablation effects produced under various voltage and power settings.