Life | Special Issue : Gastrointestinal Health: Clinical Research and Therapeutic Innovations

Research

17 pages, 453 KiB

Open AccessArticle

Impact of Depression on Health-Related Quality of Life in Ulcerative Colitis Patients—Are We Doing Enough? A Single Tertiary Center Experience

by Dunja Jaksic, Sasa Vuksanovic, Aleksandar Toplicanin, Jelena Spiric-Milovancevic, Gorica Maric and Aleksandra Sokic-Milutinovic

Life 2025, 15(4), 612; https://doi.org/10.3390/life15040612 - 6 Apr 2025

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Abstract

Ulcerative colitis (UC) significantly impacts patients’ health-related quality of life (HRQOL). This study aimed to evaluate HRQOL and the factors affecting it, and the prevalence of anxiety, depression and alexythimia in patients with UC. This cross-sectional study included 248 UC patients (21 with [...] Read more.

Ulcerative colitis (UC) significantly impacts patients’ health-related quality of life (HRQOL). This study aimed to evaluate HRQOL and the factors affecting it, and the prevalence of anxiety, depression and alexythimia in patients with UC. This cross-sectional study included 248 UC patients (21 with proctitis, 63 with left-sided UC and 164 with extensive colitis). Data were collected using standardized self-administered questionnaires [a socio-demographic questionnaire, General Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Toronto Alexithymia Scale (TAS-20) and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ)]. Clinical data on remission status, extraintestinal manifestations, comorbidities and the use of advanced therapies were also collected. Hierarchical regression analysis of variables predicting SIBDQ score was done. Clinical and laboratory remission was present in 95.6% of the patients. The prevalences of depression, anxiety and alexithymia were 44.7%, 34.3% and 30.2%, respectively. There were no differences in the PHQ-9, GAD-7 and TAS-20 scores in relation to remission status. The average SIBDQ score was 56.5. The patients in remission reported better SIBDQ scores compared to the symptomatic patients (p = 0.002). The hierarchical regression analysis showed that remission of disease and a higher depression score influenced HRQOL in the UC patients. The prevalence of depression, anxiety and alexithymia in the UC patients was high. Remission of disease and a high depression score were the main factors related to HRQOL. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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15 pages, 773 KiB

Open AccessEditor’s ChoiceArticle

The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis

by Jaewon Huh and Min Suk Chae

Life 2025, 15(2), 297; https://doi.org/10.3390/life15020297 - 14 Feb 2025

Cited by 1 | Viewed by 681

Abstract

Background: Effective pain management is essential to early extubation and recovery in living donor liver transplantation (LDLT). The subcostal transversus abdominis plane (TAP) block has emerged as a potential strategy to address postoperative pain while reducing opioid consumption. This study evaluated the effectiveness [...] Read more.

Background: Effective pain management is essential to early extubation and recovery in living donor liver transplantation (LDLT). The subcostal transversus abdominis plane (TAP) block has emerged as a potential strategy to address postoperative pain while reducing opioid consumption. This study evaluated the effectiveness of the TAP block in facilitating early extubation in the OR and examined its impact on re-intubation rates, postoperative fentanyl requirements, and pain intensity upon ICU admission to determine its role in perioperative pain management. Methods: This retrospective cohort study included adult patients who underwent LDLT for hepatocellular carcinoma within the Milan criteria. Propensity score matching was performed to compare outcomes between patients who received the subcostal TAP block and those who did not. The primary outcome was the rate of successful extubation in the operating room (OR). Secondary outcomes included re-intubation rates, postoperative fentanyl requirements, and peak numeric rating scale (NRS) pain scores upon ICU admission. Results: The subcostal TAP block was associated with a significantly higher rate of successful OR extubation compared with no TAP block. Multivariable analysis revealed that the TAP block independently increased the likelihood of successful extubation. Patients receiving the TAP block required less fentanyl for pain management and demonstrated lower peak NRS pain scores upon ICU admission. No complications related to the TAP block were observed, underscoring its safety in this high-risk population. Conclusions: The subcostal TAP block facilitates early OR extubation by effectively managing postoperative pain and reducing opioid requirements, promoting smoother recovery without increasing adverse events. These findings support its inclusion in multimodal analgesia protocols for optimizing perioperative outcomes in LDLT patients. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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11 pages, 837 KiB

Open AccessArticle

Epidemiology of Biliary Acute Pancreatitis—A Seven-Year Experience of a Large Tertiary Center

by Andrei Vicențiu Edu, Mihai Radu Pahomeanu, Alexandru Olăreanu, Dana Gabriela Corbu, Andreea Ramona Treteanu, Alexandru Constantinescu, Vasile Șandru, Narcis Octavian Zărnescu and Lucian Negreanu

Life 2025, 15(2), 139; https://doi.org/10.3390/life15020139 - 21 Jan 2025

Cited by 1 | Viewed by 1059

Abstract

(1) Introduction: One of the most common causes of acute pancreatitis is cholelithiasis, which is considered to be associated with female sex, older age, and recurrence. Our aim was to define a group of patients with B-AP to facilitate their diagnosis and management, [...] Read more.

(1) Introduction: One of the most common causes of acute pancreatitis is cholelithiasis, which is considered to be associated with female sex, older age, and recurrence. Our aim was to define a group of patients with B-AP to facilitate their diagnosis and management, while more judiciously using medical resources. (2) Materials and Methods: This retrospective, large cohort study, which was conducted by extracting data from the BUC-API registry, consisted of 1855 cases between 1 June 2015 and 1 April 2022. Each admission of the same patient was considered a separate case if it did not have signs of chronic pancreatitis. Severity and morphology were stratified according to the Revised Atlanta Classification. (3) Results: A total of 732 cases of B-AP were analyzed, with 92.5% occurring at the first attack. The median age was 65 years, with 61.9% of the patients being female. The majority (82.2%) were surgical cases, and the length of stay (LoS) was 7 days. There were 10.2% severe cases, with a mortality rate of 4%. (4) Discussion: We found positive associations between sex, age, recurrence, and morphology and biliary etiology. Compared with the general population, female sex and age over 65 years correlate better with a biliary etiology. In most scenarios, patients suffer from first attacks, with a lower probability of developing local complications. There was a tendency for biliary pancreatitis patients to be admitted to surgical wards. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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14 pages, 943 KiB

Open AccessArticle

Laparoscopic and Open Distal Pancreatectomy—An Initial Single-Institution Experience with a Propensity Score Matching Analysis

by Irena Plahuta, Žan Šarenac, Medeja Golob, Špela Turk, Bojan Ilijevec, Tomislav Magdalenić, Stojan Potrč and Arpad Ivanecz

Life 2025, 15(1), 97; https://doi.org/10.3390/life15010097 - 14 Jan 2025

Viewed by 1058

Abstract

Laparoscopic distal pancreatectomy is a minimally invasive approach for the surgical treatment of neoplasms in the distal pancreas. This study aimed to compare this approach to the open procedure. A retrospective analysis of a prospectively maintained database of 400 pancreatectomies was performed. The [...] Read more.

Laparoscopic distal pancreatectomy is a minimally invasive approach for the surgical treatment of neoplasms in the distal pancreas. This study aimed to compare this approach to the open procedure. A retrospective analysis of a prospectively maintained database of 400 pancreatectomies was performed. The laparoscopic distal pancreatectomy group (LDP) was compared to the open distal pancreatectomy group (ODP). A propensity score matching analysis (PSM) was performed. From 2016 to 2023, 108 distal pancreatectomies were carried out, 19 (17.6%) laparoscopically and 89 (82.4%) openly. The conversion rate was 13.6%. The severe morbidity rates were 28.1% in the ODP group, 47.4% in the LDP group, and 15.8% in the ODP-PSM group. The difference between the latter two was statistically significant (p = 0.034) due to the high rate of Clavien–Dindo grade 3a complications (42.1% versus 10.5%, p = 0.042) in the LDP group. The 90-day mortality rates were 3.3% in the ODP group and 5.3% in the other two groups. The LDP group had a shorter duration of intravenous narcotic analgesia (5 versus 7 days, p = 0.041). There was no difference in the R0 resection or postoperative pancreatic fistula rates. Our attention should be drawn to preventing postoperative complications because the oncological outcomes are already comparable with those of the open procedure, and postoperative pain management is promising. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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8 pages, 210 KiB

Open AccessArticle

Fruit and Vegetable Consumption and Inflammatory Bowel Disease: A Case-Control Study

by Anas M. Almofarreh, Haytham A. Sheerah, Ahmed Arafa, Fairuz A. Algori, Ghonem R. Almutairi, Kafi A. Alenzi, Madiha M. Al-Alsehemi, Banan H. Mekwar, Osama Alzeer and Haneen N. Molla

Life 2024, 14(12), 1524; https://doi.org/10.3390/life14121524 - 21 Nov 2024

Viewed by 1045

Abstract

Background: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic conditions with complex etiologies that may involve dietary factors. This study investigates the association between fruit and vegetable consumption and the risk of UC and CD, focusing on [...] Read more.

Background: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic conditions with complex etiologies that may involve dietary factors. This study investigates the association between fruit and vegetable consumption and the risk of UC and CD, focusing on gender-specific differences. Methods: A hospital-based case–control study, comprising 158 UC patients (93 men and 65 women), 245 CD patients (167 men and 78 women), and 395 controls without IBD (256 men and 139 women), was conducted in Riyadh, Saudi Arabia. Fruit and vegetable consumption data were gathered through a self-administered questionnaire distributed before diagnosis. Logistic regression analysis was applied to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for UC and CD among the participants reporting the daily consumption of fruits and vegetables. Results: Among men, daily vegetable consumption was associated with higher odds of UC in the age-adjusted model [OR (95% CI): 1.78 (1.02, 3.10)], but this association became non-significant after further adjustment for body mass index, smoking, anemia, and elevated liver enzymes [OR (95% CI): 1.70 (0.91, 3.18)]. No significant associations were observed between vegetable consumption and CD. In contrast, the women who consumed vegetables every day had a non-significant inverse association with UC and a significant inverse association with CD in both the age-adjusted and multivariable-adjusted models [ORs (95% CIs): 0.44 (0.23, 0.87) and 0.41 (0.20, 0.84), respectively]. Fruit consumption was neither associated with UC nor CD in either sex. Conclusions: Daily vegetable consumption was significantly associated with decreased odds of CD among women, but not men, highlighting potential sex-specific dietary influences on IBD risk. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

12 pages, 2318 KiB

Open AccessArticle

Phase Angle (PhA) Is an Easy and Complementary Tool for Assessing Nutritional Status in Ulcerative Colitis (UC) Patients: A Cross-Sectional Study

by Viridiana Montsserrat Mendoza-Martínez, Roberto Baños-Vázquez, Guillermo Melendez-Mier, Javier Ivanovychs Carrillo-Rojas, Martha Alison Santoyo-Chávez, Sarahi Ontiveros-López, Annel Gómez-Coello, Galileo Escobedo, Jorge Luis de León-Rendón and Nallely Bueno-Hernández

Life 2024, 14(11), 1511; https://doi.org/10.3390/life14111511 - 20 Nov 2024

Cited by 1 | Viewed by 1089

Abstract

Background: Accumulating evidence has proposed phase angle (PhA) as a marker for assessing cellular integrity and nutritional status in ulcerative colitis (UC) patients; the aim of the study was to evaluate the efficacy of PhA in assessing nutritional status in patients with UC, [...] Read more.

Background: Accumulating evidence has proposed phase angle (PhA) as a marker for assessing cellular integrity and nutritional status in ulcerative colitis (UC) patients; the aim of the study was to evaluate the efficacy of PhA in assessing nutritional status in patients with UC, investigating its potential as a biomarker of disease activity. Methods: We conducted a cross-sectional study in patients with UC and healthy controls. We determined PhA by electrical bioimpedance and categorized participants through bioelectrical impedance analysis. They were classified as normal PhA > 6.1° and low PhA < 6.1° in men and normal PhA > 5.6° and low PhA < 5.6° in women. Results: PhA was significantly lower in UC patients than in controls (5.8 ± 0.8 vs. 6.6 ± 0.7°; p < 0.001). Among UC patients, participants with low PhA showed a decrease in lean, dry mass (LDM) (p < 0.001), total body water (p = 0.008), and intracellular water (p = 0.005), accompanied by an increase in extracellular water (p = 0.001) compared to UC patients with normal PhA. Conclusions: PhA significantly decreases in UC patients compared to healthy controls and is even more reduced when UC is active. A cut-off point of <6.1 for men and <5.6 for women could be suitable for nutritional diagnosis in patients with UC, but it still needs to be validated. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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15 pages, 267 KiB

Open AccessArticle

New Approaches Based on Inflammatory Indexes in the Evaluation of the Neoplastic Potential of Colon Polyps

by Sedat Ciftel, Serpil Ciftel, Aleksandra Klisic and Filiz Mercantepe

Life 2024, 14(10), 1259; https://doi.org/10.3390/life14101259 - 2 Oct 2024

Cited by 1 | Viewed by 1393

Abstract

Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective [...] Read more.

Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective cross-sectional study was conducted on 758 patients aged 61.0 ± 11.8 who underwent polypectomy between June 2021 and May 2024. Patients with colorectal adenocarcinoma (n = 22) were excluded. The polyps were classified into neoplastic and nonneoplastic categories based on histopathological evaluation. The study compared the CALLY index, HALP score, and various inflammatory indexes between neoplastic and nonneoplastic polyps. Out of 758 polyps analyzed, 514 were neoplastic, and 244 were nonneoplastic. Neoplastic polyps exhibited significantly lower CALLY and HALP scores (p < 0.05) and higher immuno-inflammatory indexes (p < 0.05) compared to nonneoplastic polyps. Dysplasia status, polyp diameter, and sigmoid colon localization were significant factors in determining neoplastic growth potential. No significant differences were observed in polyp localization in the proximal and distal colon segments or in solitary versus multiple polyps. The CALLY and HALP scores and immuno-inflammatory indexes can serve as valuable markers for distinguishing neoplastic from nonneoplastic polyps. These indexes reflect underlying inflammatory and immune responses, highlighting their potential utility in the early detection and risk stratification of colorectal polyps. Integrating these markers into clinical practice may enhance diagnostic accuracy and improve patient management, leading to timely interventions and better outcomes for individuals at risk of CRC. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

11 pages, 268 KiB

Open AccessArticle

Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients with Inflammatory Bowel Diseases: A Pilot Study

by Ludovico Abenavoli, Rocco Spagnuolo, Giuseppe Guido Maria Scarlata, Maria Luisa Gambardella, Luigi Boccuto, Nahum Méndez-Sánchez and Francesco Luzza

Life 2024, 14(10), 1226; https://doi.org/10.3390/life14101226 - 25 Sep 2024

Cited by 6 | Viewed by 1885

Abstract

Background: Inflammatory bowel disease (IBD) is characterized by persistent inflammation and is often associated with metabolic dysfunction-associated steatotic liver disease (MASLD). IBD patients are at risk of developing MASLD due to shared risk factors such as gut dysbiosis and systemic inflammation. The new [...] Read more.

Background: Inflammatory bowel disease (IBD) is characterized by persistent inflammation and is often associated with metabolic dysfunction-associated steatotic liver disease (MASLD). IBD patients are at risk of developing MASLD due to shared risk factors such as gut dysbiosis and systemic inflammation. The new MASLD nomenclature emphasizes the link between liver steatosis and cardiometabolic comorbidities. However, the prevalence of MASLD in IBD patients remains poorly explored. The main aim of this cross-sectional study is to assess the prevalence of ultrasound (US) and the clinical features of MASLD in patients with IBDs. Materials and Methods: We conducted a retrospective study enrolling 272 Italian IBD patients attending Renato Dulbecco Teaching Hospital in a period between 1 January 2021 and 31 December 2023. MASLD was diagnosed based on the presence of liver steatosis with cardiometabolic risk factors, using established guidelines. Demographic, clinical, and laboratory data were collected and analyzed. Statistical significance was determined at a p-value < 0.05. Results: Of the 272 IBD patients, 6% had non-alcoholic fatty liver disease (NAFLD), while 18% had MASLD. Patients with IBD-MASLD were significantly older, had higher body mass index, waist circumference, and triglyceride levels, and were more likely to have type 2 diabetes mellitus and hypertension compared to those with IBD-NAFLD. IBD-MASLD patients also showed higher disease activity scores and required more frequent surgical interventions. Bivariate logistic regression revealed triglyceride levels as a significant predictor of MASLD in IBD patients. Conclusions: MASLD is more prevalent in IBD patients, highlighting the importance of early detection of liver steatosis in this at-risk population. The association between MASLD and cardiometabolic risk factors underscores the need for a multidisciplinary approach to manage these patients effectively. Further studies in larger cohorts are necessary to confirm these findings and explore the pathophysiological mechanisms involved. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

12 pages, 3582 KiB

Open AccessArticle

The Hepatoprotective Effects of Camellia sinensis on Cisplatin-Induced Acute Liver Injury

by Adnan Yilmaz, Fatih Dizman, Kerimali Akyildiz, Sibel Mataraci Karakas, Tolga Mercantepe, Huseyin Avni Uydu, Levent Tumkaya and Koksal Ozturk

Life 2024, 14(9), 1077; https://doi.org/10.3390/life14091077 - 28 Aug 2024

Cited by 2 | Viewed by 1368

Abstract

Acute liver injury is an increasing global health problem. It is a widespread side effect of cisplatin treatment in the clinic and can lead to liver failure if not treated promptly. Previous studies have revealed that green tea can protect some organs from [...] Read more.

Acute liver injury is an increasing global health problem. It is a widespread side effect of cisplatin treatment in the clinic and can lead to liver failure if not treated promptly. Previous studies have revealed that green tea can protect some organs from treatments. However, the potential of white tea to prevent the negative effects of acute liver injury has not been addressed so far. The purpose of this study was to investigate the reduction in cisplatin-induced liver injury in rats receiving white tea. Female Sprague Dawley rats with similar weight were selected in this study. Twenty-four rats were divided into three groups of eight animals each and ad libitum nutrition was provided. The control and cisplatin groups were given tap water only, while the white tea + cisplatin group received white tea at a 0.5% weight/volume concentration for four weeks. At the end of the fourth week, the white tea + cisplatin group and the cisplatin group received a single dose of cisplatin (7 mg/kg) via the intraperitoneal route. Five days after that procedure, the rats were anesthetized. Liver tissues and blood samples were collected, which were used for biochemical and histopathological analyses. According to biochemical results, liver tissue MDA and GSH, serum ALT, and AST levels significantly increased in the cisplatin group compared to the control group. Compared with the cisplatin group, although MDA, AST, ALT, and GSH levels were lower in the white tea + cisplatin group, only GSH levels were statistically different. The examination of histopathological and immunohistochemical findings revealed apoptotic cells, vascular congestion, and sinusoidal dilatation in the cisplatin group compared to the control group. This adverse event decreased in the white tea + cisplatin group compared to the cisplatin group. In conclusion, white tea exhibits an ameliorating effect on cisplatin-induced liver injury. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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Review

Jump to: Research, Other

14 pages, 659 KiB

Open AccessReview

Backwash Ileitis—From Pathogenesis to Clinical Significance: Literature Review

by Alina-Ecaterina Jucan, Otilia Nedelciuc, Vasile-Claudiu Mihai, Mihaela Dranga, Mihaela-Cristiana Andronic, Simona-Stefania Juncu, Georgiana-Elena Sarbu, Ioana-Ruxandra Mihai, Andrei Andronic, Irina Ciortescu, Vasile Drug, Cristina Cijevschi Prelipcean and Catalina Mihai

Life 2025, 15(4), 567; https://doi.org/10.3390/life15040567 - 31 Mar 2025

Viewed by 622

Abstract

Backwash ileitis (BWI) refers to inflammation in the distal ileum in patients with extensive ulcerative colitis (UC) that is thought to be caused by a “reflux” or “backwash” of colonic contents. In the absence of well-defined diagnostic criteria for BWI, more recently, the [...] Read more.

Backwash ileitis (BWI) refers to inflammation in the distal ileum in patients with extensive ulcerative colitis (UC) that is thought to be caused by a “reflux” or “backwash” of colonic contents. In the absence of well-defined diagnostic criteria for BWI, more recently, the term UC-associated ileitis was proposed in favor of the backwash theory, which questions the existence of backwash ileitis as a distinct disease-specific subset of patients. Moreover, distinguishing UC-associated BWI from terminal ileitis of Crohn’s disease or other conditions could be a diagnostic challenge and significantly affect treatment management. Therefore, clinical, endoscopic, histologic, and imagistic diagnostic features may aid in making this distinction. This literature review related to BWI outlines the hypothesis that the ileum may also become involved in UC as a primary manifestation of UC based on recent findings. This study also highlights the possibility that associated ileitis in UC patients may represent a potential risk factor for neoplasia, a positive association with primary sclerosing cholangitis, and a higher risk for the subsequent development of pouchitis after restorative proctocolectomy. It synthesizes recent key findings and highlights areas for further research. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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15 pages, 752 KiB

Open AccessReview

Inflammatory Bowel Diseases and Nephropathies: Exploring the Gut–Kidney Axis

by Roberto de Sire, Alessia La Mantia, Livio Bonacci, Anna Testa, Alessia Dalila Guarino, Antonio Rispo, Olga Maria Nardone and Fabiana Castiglione

Life 2024, 14(12), 1541; https://doi.org/10.3390/life14121541 - 25 Nov 2024

Cited by 1 | Viewed by 1784

Abstract

Inflammatory bowel disease (IBD) can extend beyond the gastrointestinal tract, affecting extraintestinal organs and significantly increasing morbidity and mortality. Despite early studies revealing kidney involvement in nearly a quarter of patients with IBD, renal manifestations have been notably overlooked. Among these manifestations, nephrolithiasis, [...] Read more.

Inflammatory bowel disease (IBD) can extend beyond the gastrointestinal tract, affecting extraintestinal organs and significantly increasing morbidity and mortality. Despite early studies revealing kidney involvement in nearly a quarter of patients with IBD, renal manifestations have been notably overlooked. Among these manifestations, nephrolithiasis, obstructive uropathy, and fistula formation between the bowel and urinary tract are the most reported occurrences. Additionally, renal parenchymal involvement in IBD, including glomerulonephritis (GN), tubulointerstitial nephritis, and amyloidosis, has been documented. GN is particularly noteworthy, as a significant proportion of patients progress to end-stage kidney disease (ESKD). Although GN has long been recognized as a potential extraintestinal manifestation (EIM) of IBD, it has often been dismissed as an anecdotal association. Recently, several studies highlighted the clinical correlation between GN and IBD, suggesting a pathogenic interplay involving gut inflammation, dysbiosis, and intrinsic glomerular processes. Thus, our objective is to elucidate the basis of IBD-related nephropathies, with a specific focus on IgA nephropathy (IgAN) and the gut–kidney axis. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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11 pages, 7581 KiB

Open AccessReview

Management of a Rare Case of Superior Mesenteric Artery Aneurysm Associated with a Pancreatic Cyst Complicated by Acute Rupture: A Case Report and Review of Literature

by Petru Razvan Dragulescu, Roxana Carmen Geana (Anghel), Mircea Robu, Reza Nayyerani, Cristian Dumitrescu, Anca Dragan, Catalin Vasilescu, Vlad Anton Iliescu and Ovidiu Stiru

Life 2024, 14(11), 1348; https://doi.org/10.3390/life14111348 - 22 Oct 2024

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Abstract

Superior mesenteric artery aneurysms are a rare pathology, and rupture due to a pancreatic cyst in the context of alcohol-induced pancreatitis is an even rarer condition. The first line of treatment is usually an endovascular approach. We present the case of a 51-year-old [...] Read more.

Superior mesenteric artery aneurysms are a rare pathology, and rupture due to a pancreatic cyst in the context of alcohol-induced pancreatitis is an even rarer condition. The first line of treatment is usually an endovascular approach. We present the case of a 51-year-old male with alcohol-induced pancreatitis, diagnosed with a superior mesenteric artery aneurysm with active bleeding in close contact with a large pancreatic cyst. A covered stent was used to treat this condition. The patient developed hemorrhagic shock 12 h after the procedure and an urgent laparotomy was performed. A second rupture of the arterial wall at the distal end of the stent was observed and in order to obtain distal perfusion, first, an infrarenal aorta to superior mesenteric artery bypass distal to the rupture was performed in order to exclude the aneurysm. Secondly, a bypass originating from the distal end of the first bypass to the distal end of the superior mesenteric artery was performed. The patient had an uneventful recovery and was discharged after 10 days. We reviewed the literature regarding the incidence and the therapeutic management of superior mesenteric artery aneurysm complicated by pancreatic cyst. An advanced search on PubMed from 2004 to 2024 returned 194 results and after applying the inclusion–exclusion criteria, 11 publications were selected. Although the endovascular approach is usually the first line of treatment with obvious advantages for the patient, a patient-tailored approach should be made in such cases and surgery could be the first option, when considering that the mechanism of aneurysm rupture is due to erosion of the arterial wall by the pancreatic enzymes. Surgery has the advantage of cyst drainage and aneurysm exclusion and in our case proved lifesaving. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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Other

Jump to: Research, Review

8 pages, 3934 KiB

Open AccessCase Report

Rectal Administration of Rifampicin and Isoniazid Suppositories: An Alternative Approach for the Treatment of Tuberculosis in a Patient with Multiple Comorbidities

by Ioana Munteanu, Beatrice Burdușel, Catalin Constantin Coca, Dănuț Zisu, Constantin Gheorghevici, George Alexandru Diaconu, Diana Georgiana Stan, Nicolae Feraru, Andrei Tivda, Cristian George Popa, Florin Dumitru Mihălțan and Corina Marginean

Life 2025, 15(5), 773; https://doi.org/10.3390/life15050773 - 12 May 2025

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Abstract

This article reports the case of a patient with a gastric neoplasm and total gastrectomy, presenting with severe digestive intolerance, who developed peritoneal and pulmonary tuberculosis. Standard treatment could not be administered. Therefore, treatment was initiated with isoniazid and rifampicin suppositories, and intravenous [...] Read more.

This article reports the case of a patient with a gastric neoplasm and total gastrectomy, presenting with severe digestive intolerance, who developed peritoneal and pulmonary tuberculosis. Standard treatment could not be administered. Therefore, treatment was initiated with isoniazid and rifampicin suppositories, and intravenous levofloxacin and amikacin, with significant remission of the digestive symptomatology. Although treatment with rifampicin suppositories has demonstrated efficacy in tuberculosis, it is rarely used in practice. This case highlights the importance of individualizing tuberculosis treatment and demonstrates that rectal administration of isoniazid and rifampicin suppositories, combined with intravenous levofloxacin and amikacin, was successfully used to treat tuberculosis in a patient with severe digestive intolerance, highlighting a potential alternative regimen when standard oral therapy is not feasible. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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8 pages, 1007 KiB

Open AccessCase Report

A Case of a Neuroendocrine Tumor in a Liver Transplant Patient: Diagnostic and Management Difficulties

by Carmen Colaci, Caterina Mercuri, Alessandro Corea, Rocco Spagnuolo and Patrizia Doldo

Life 2025, 15(3), 421; https://doi.org/10.3390/life15030421 - 7 Mar 2025

Viewed by 545

Abstract

Neuroendocrine tumors (NETs) of the liver are a rare entity. NETs are often poorly recognized, with diagnostic difficulties and differential challenges between primary tumors of the liver and metastases from other organs, mainly from the gastrointestinal tract. Multidisciplinary and multi-technical diagnosis is mandatory [...] Read more.

Neuroendocrine tumors (NETs) of the liver are a rare entity. NETs are often poorly recognized, with diagnostic difficulties and differential challenges between primary tumors of the liver and metastases from other organs, mainly from the gastrointestinal tract. Multidisciplinary and multi-technical diagnosis is mandatory to properly treat these tumors. This case describes the complex history and the treatment course of a 68-year-old man with a history of NET onset after liver transplantation. Liver transplantation is the treatment of choice for patients with advanced liver disease or acute liver failure, but careful pre- and post-transplant patient monitoring is required. Liver transplant patients receive immunosuppressive therapy, and donor livers should be screened to exclude potential malignancies. This clinical case, in addition to emphasizing the diagnostic and therapeutic difficulty of hepatic NET, underlines the role of post-transplant immunosuppressive therapy and pre-transplant screening, which includes a thorough evaluation of donor and recipient history, physical examination, and laboratory tests. Moreover, post-transplant immunosuppressive therapy is essential to maintain the viability of the transplanted organ, but it is not free from potential risks, including an increased risk of cancer. Therefore, close monitoring of therapy is necessary to optimize long-term results and the patient’s quality of life. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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12 pages, 1474 KiB

Open AccessSystematic Review

Efficacy of Dupilumab in the Treatment of Eosinophilic Esophagitis: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

by Szu-Hung Chu, Jeng-Jung Chen, Chung-Chu Chen, Wei-Te Lei, Chi-Hone Lien, Shung-Long Weng, Chun-Yan Yeung, Lawrence Yu-Ming Liu, Yu-Lin Tai, Ya-Ning Huang and Chien-Yu Lin

Life 2025, 15(2), 307; https://doi.org/10.3390/life15020307 - 17 Feb 2025

Viewed by 1420

Abstract

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder of the esophagus with rising prevalence. Dupilumab (DUPI), a monoclonal antibody that targets the interleukin-4 receptor α, has shown promise as a treatment option. We conducted a systematic review and network meta-analysis of randomized controlled [...] Read more.

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disorder of the esophagus with rising prevalence. Dupilumab (DUPI), a monoclonal antibody that targets the interleukin-4 receptor α, has shown promise as a treatment option. We conducted a systematic review and network meta-analysis of randomized controlled trials searching the PubMed/Medline database, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), and the medRxiv preprint server up to 31 July 2024, assessing DUPI’s efficacy and optimal dosing in the treatment of EoE. Finally, three randomized-controlled trials comprising 470 participants, including 102 children under 12 years of age, were included in the qualitative synthesis. Both high-exposure (HE-DUPI, 300 mg weekly) and low-exposure (LE-DUPI, 300 mg biweekly) regimens achieved significant histologic remission relative to placebo (OR = 26.88, 95% CI 11.98–60.29 for LE-DUPI; OR = 29.15, 95% CI 13.68–62.12 for HE-DUPI). Although overall adverse events were comparable between groups, HE-DUPI was associated with a notable increase in serious adverse events. These findings suggest that DUPI is effective in promoting histologic remission in EoE, with LE-DUPI emerging as a preferred option for balancing efficacy and safety. This study highlights the efficacy and safety profiles of different dosing regimens and pediatric groups. Further studies are warranted to explore long-term outcomes and identify patient subgroups that may derive the greatest benefit from DUPI therapy. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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Open AccessCase Report

Application of Functional Neurology Therapy in a Lactose-Intolerant Patient

by Jorge Rey-Mota, Guillermo Escribano-Colmena, David Martín-Caro Álvarez, Jhulliana Vasquez Perez, Eduardo Navarro-Jimenez and Vicente Javier Clemente-Suárez

Life 2024, 14(8), 978; https://doi.org/10.3390/life14080978 - 4 Aug 2024

Cited by 7 | Viewed by 1998

Abstract

This case report examines the impact of a single session of functional neurology on a 35-year-old female patient diagnosed with lactose intolerance. The patient presented with severe gastrointestinal symptoms, including frequent diarrhea, bloating, and vomiting upon dairy consumption. The intervention aimed to reset [...] Read more.

This case report examines the impact of a single session of functional neurology on a 35-year-old female patient diagnosed with lactose intolerance. The patient presented with severe gastrointestinal symptoms, including frequent diarrhea, bloating, and vomiting upon dairy consumption. The intervention aimed to reset dysfunctional neurological programs believed to contribute to her condition. The study utilized a standardized lactose intolerance breath test to measure the hydrogen and methane levels at various intervals before and after treatment. Post-treatment results showed symptomatic relief with the patient reporting normalized bowel movements and the absence of previous symptoms. Despite these improvements, the biochemical markers at higher time points (150 and 175 min) post-treatment remained similar to the pre-treatment values, indicating persistent lactose malabsorption and highlighting the variability of hydrogen measurements. This case report suggests that a single session of functional neurology can significantly alleviate the symptoms of lactose intolerance. However, the preliminary nature of these results underscores the need for further research involving larger sample sizes and long-term follow-up to fully understand the treatment’s efficacy and underlying mechanisms. Full article

(This article belongs to the Special Issue Gastrointestinal Health: Clinical Research and Therapeutic Innovations)

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