• Title/Summary/Keyword: Gastroenterology

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Efficacy, immunogenicity, and safety of COVID-19 vaccines in individuals with liver cirrhosis: a rapid review and meta-analysis

  • Faranak Salajegheh;Mohammad Rezaei Zadeh Rukerd;Mohsen Nakhaie;Zohreh-Al-Sadat Ghoreshi;Javad Charostad;Nasir Arefinia
    • Clinical and Experimental Vaccine Research
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    • v.13 no.2
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    • pp.83-90
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    • 2024
  • The emergence of coronavirus disease 2019 (COVID-19) vaccines has been a remarkable advancement. However, the efficacy, immunogenicity, and safety of these vaccines in individuals with liver cirrhosis require careful evaluation due to their compromised immune status and potential interactions with underlying liver disease. The present study aimed to evaluate the safety and efficacy of COVID-19 vaccines in liver cirrhosis patients. In the present study, we searched international databases, including Google Scholar, PubMed, Scopus, Embase, and Web of Science. The search strategy was carried out by using keywords and MeSH (Medical Subject Headings) terms. STATA ver. 15.0 (Stata Corp., USA) was used to analyze the data statistically. The analysis was performed using the randomeffects model. We also used the chi-square test and I2 index to calculate heterogeneity among studies. For evaluating publication bias, Begg's funnel plots and Egger's tests were used. A total of 4,831 liver cirrhosis patients with COVID-19 were examined from 11 studies. The rate of hospitalization in the patients with liver cirrhosis was 17.6% (95% confidence interval [CI], 9%-44%). The rate of fever in the patients with liver cirrhosis was 4.5% (95% CI, 0.9%-8.1%). The rate of positive neutralizing antibodies in the patients with liver cirrhosis was 82.5% (95% CI, 69.8%-95.1%). Also, the rates of seroconversion after the second vaccination in patients with liver cirrhosis and the control group were 96.6% (95% CI, 92.0%-99.0%), and 99.7% (95% CI, 99.0%-100.0%), respectively. COVID-19 vaccines have demonstrated promising efficacy, immunogenicity, and safety profiles in individuals with liver cirrhosis, providing crucial protection against COVID-19-related complications.

Puncture angle on an endoscopic ultrasound image is independently associated with unsuccessful guidewire manipulation of endoscopic ultrasound-guided hepaticogastrostomy: a retrospective study in Japan

  • Akihisa Ohno;Nao Fujimori;Toyoma Kaku;Kazuhide Matsumoto;Masatoshi Murakami;Katsuhito Teramatsu;Keijiro Ueda;Masayuki Hijioka;Akira Aso;Yoshihiro Ogawa
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.656-665
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    • 2024
  • Background/Aims: Although endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is performed globally, the procedure remains challenging. Guidewire manipulation is the most difficult step, and there are few reports on the factors associated with unsuccessful guidewire manipulation. This study aimed to assess the significance of the puncture angle on EUS images and identify the most effective guidewire rescue method for patients with unsuccessful guidewire manipulation. Methods: We retrospectively enrolled 115 patients who underwent EUS-HGS between May 2016 and April 2022 at two centers. The puncture angle between the needle and the intrahepatic bile duct was measured through EUS movie records. Results: Guidewire manipulation was unsuccessful in 28 patients. Receiver operating characteristic (ROC) curves identified an optimal puncture angle cutoff value of 85° (cutoff value, 85°; area under the ROC curve, 0.826; sensitivity, 85.7%; specificity, 81.6%). Multivariate analysis demonstrated that a puncture angle <85° was a significant risk factor for unsuccessful guidewire manipulation (odds ratio, 19.8; 95% confidence interval, 6.42-61.5; p<0.001). Among the 28 unsuccessful cases, 24 patients (85.7%) achieved successful guidewire manipulation using various rescue methods. Conclusions: The puncture angle observed on EUS is crucial for guidewire manipulation. A puncture angle of <85° was associated with unsuccessful guidewire manipulation.

Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand

  • Tharathorn Suwatthanarak;Chainarong Phalanusitthepa;Chatbadin Thongchuam;Thawatchai Akaraviputh;Vitoon Chinswangwatanakul;Thikhamporn Tawantanakorn;Somchai Leelakusolvong;Monthira Maneerattanaporn;Piyaporn Apisarnthanarak;Jitladda Wasinrat
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.610-619
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    • 2024
  • Background/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM. Methods: This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up. Results: Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017). Conclusions: These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

How to approach feeding difficulties in young children

  • Yang, Hye Ran
    • Clinical and Experimental Pediatrics
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    • v.60 no.12
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    • pp.379-384
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    • 2017
  • Feeding is an interaction between a child and caregiver, and feeding difficulty is an umbrella term encompassing all feeding problems, regardless of etiology, severity, or consequences, while feeding disorder refers to an inability or refusal to eat sufficient quantities or variety of food to maintain adequate nutritional status, leading to substantial consequences, including malnutrition, impaired growth, and possible neurocognitive dysfunction. There are 6 representative feeding disorder subtypes in young children: infantile anorexia, sensory food aversion, reciprocity, posttraumatic type, state regulation, and feeding disorders associated with concurrent medical conditions. Most feeding difficulties are nonorganic and without any underlying medical condition, but organic causes should also be excluded from the beginning, through thorough history taking and physical examination, based on red-flag symptoms and signs. Age-appropriate feeding principles may support effective treatment of feeding difficulties in practice, and systematic approaches for feeding difficulties in young children, based on each subtype, may be beneficial.

The roles of endoscopic ultrasound in the diagnosis of pancreatobiliary cancer (췌·담도암 진단에 있어서 내시경초음파의 역할)

  • Kim, Kook Hyun
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.77-84
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    • 2016
  • Pancreatic cancer, the 4th leading cause of cancer-related death in the United States, has a very poor prognosis. Cholangiocarcinoma originates from either intrahepatic or extrahepatic bile duct, and its incidence is gradually increasing worldwide. Endoscopic retrograde cholangiopancreatography with brush cytology has a high false-negative rate for the diagnosis of biliary malignancy. Recently, endoscopic ultrasonography (EUS) has emerged as the potential modality to detect pancreatic cancer. EUS-guided fine needle aspiration for cytologic analysis made it possible to overcome the obstacle in differentiating between benign and malignant lesions in the pancreatobiliary lesion, and it has been well established as a safe and effective procedure. Herein, the clinical application of EUS in the diagnosis of pancreatobiliary cancer was reviewed.

A Case of Biliary Ascariasis in Korea

  • Choi, Jun-Ho;Seo, Min
    • Parasites, Hosts and Diseases
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    • v.55 no.6
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    • pp.659-660
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    • 2017
  • Biliary ascariasis is still the leading cause of surgical complication of ascariasis, though its incidence has been dramatically reduced. Herein, we report a case of biliary ascariasis for the purpose of enhancing awareness of parasitic infections as a possible cause. A 72-year-old male visited the emergency room of Dankook University Hospital on 12 July 2015, complaining of right-upper-quadrant pain. By endoscopic retrograde cholangiopancreatography (ERCP), a tubular filling defect in the right hepatic duct was detected. The defect was endoscopically removed and diagnosed as an adult female of Ascaris lumbricoides worm, of 30 cm length. Upon removal of the worm, the pain subsided, and the patient was discharged without any complication. When treating cases of biliary colic, physicians should not neglect biliary ascariasis as the possible cause.

An overview and the future of pediatric subspecialty board certification of the Korean Pediatric Society (대한소아과학회 세부전문의 제도의 현황과 미래)

  • Lee, Chong Guk
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.555-558
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    • 2008
  • Committee for pediatric subspecialty board certification of the Korean Pediatric Society (KPA) was established for the subspecialty certification and formal training programs in 2005. Pediatric allergy and pulmonology was the first pediatric subspecialty among 9 subdivisions of KPA to petition for the certification in 2006, and 7 additional subdivisions of KPA, pediatric cardiology, pediatric endocrinology, pediatric gastroenterology and nutrition, pediatric infectious diseases, neonatology, pediatric nephrology, pediatric neurology, respectively, were followed in 2007. Finally, pediatric hemato-oncology joined this program in 2008. An overview and the future of Korean pediatric subspecialties are described.

Chemoprotective effects of the formulated extract DA-9601 of Artemisia asiatica against experimentally induced oxidative and inflammatory tissue damage

  • Lee, Jeong-Sang;Oh, Tae-Young;Ahn, Byung-Ok;Hyun Cho;Hahm, Ki-Baik;Surh, Young-Joon
    • Proceedings of the Korean Society of Toxicology Conference
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    • 2001.05a
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    • pp.146-146
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    • 2001
  • Gastroesophageal reflux disease (GERD) is multifactorial in etiology and is characterized by movement of acid and other noxious substances from the stomach into the esophagus. The most severe histologic consequence of chronic gastroesophgeal reflux is Barrett's esophagus, which has been considered as a premalignant condition often leading to the formation of adenocarcinoma of esophagus.(omitted)

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Drug-induced liver injury

  • Suh, Jeong Ill
    • Journal of Yeungnam Medical Science
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    • v.37 no.1
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    • pp.2-12
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    • 2020
  • Drug-induced liver injury (DILI), including herbal and dietary supplement hepatotoxicity, is often passed lightly; however, it can lead to the requirement of a liver transplant or may even cause death because of liver failure. Recently, the American College of Gastroenterology, Chinese Society of Hepatology and European Association for the Study of the Liver guidelines for the diagnosis and treatment of DILI have been established, and they will be helpful for guiding clinical treatment decisions. Roussel Uclaf Causality Assessment Method scoring is the most commonly used method to diagnose DILI; however, it has some limitations, such as poor validity and reproducibility. Recently, studies on new biomarkers have been actively carried out, which will help diagnose DILI and predict the prognosis of DILI. It is expected that the development of new therapies such as autophagy inducers and various other technologies of the fourth industrial revolution will be applicable to DILI research.